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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $77.62 | Professional | None | $38.02 | $38.02 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $7,943.28 | Facility | None | $4,786.30 | $5,888.44 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $51.29 Typical High $79.43 | Professional | None | $23.44 | $51.29 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $100.00 Typical High $2,691.53 | Facility | None | $51.29 | $100.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $114.82 | Professional | None | $38.02 | $72.44 | $114.82 |
ConnectiCare Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | None | $75.86 | $79.43 | $79.43 |
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 $29.51 Median $57.54 Typical High $123.03 | Professional | None | $29.51 | $57.54 | $123.03 |
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 $19.05 Median $19.05 Typical High $38.90 | Professional | 52 · Reduced service | $19.05 | $19.05 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $15.49 | Professional | 53 · Discontinued | $7.59 | $7.59 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.18 Typical High $58.88 | Professional | 54 · Surgery only | $28.18 | $28.18 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $11.75 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $7.76 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 24th of 51
$60.26
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.