How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $204.17 | Professional | None | $72.44 | $120.23 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $181.97 | Professional | None | $56.23 | $112.20 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $257.04 | Professional | None | $87.10 | $141.25 | $257.04 |
ConnectiCare Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | None | $162.18 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $309.03 | Professional | None | $69.18 | $138.04 | $309.03 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $100.00 | Professional | 52 · Reduced service | $46.77 | $46.77 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $39.81 | Professional | 53 · Discontinued | $18.62 | $18.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $147.91 | Professional | 54 · Surgery only | $70.79 | $70.79 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $30.20 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $19.95 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 23rd of 51
$138
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.