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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $97.72 | Professional | None | $61.66 | $67.61 | $97.72 |
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 $43.65 Median $74.13 Typical High $102.33 | Professional | None | $43.65 | $74.13 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $117.49 Typical High $154.88 | Facility | None | $51.29 | $117.49 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $141.25 | Professional | None | $61.66 | $95.50 | $141.25 |
ConnectiCare Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | None | $87.10 | $91.20 | $91.20 |
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 $48.98 Median $85.11 Typical High $141.25 | Professional | None | $48.98 | $85.11 | $141.25 |
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 $30.90 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $12.30 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $50.12 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $6.76 | $9.77 |
Where Connecticut sits
The same service costs 3.4 times more in Alaska than in New York. 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· 22nd of 51
$87.10
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.