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 $66.07 Median $95.50 Typical High $95.50 | Professional | None | $66.07 | $95.50 | $95.50 |
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 $52.48 Median $74.13 Typical High $95.50 | Professional | None | $52.48 | $74.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $851.14 Typical High $1,023.29 | Facility | None | $51.29 | $851.14 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $147.91 | Professional | None | $89.13 | $100.00 | $147.91 |
ConnectiCare Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | None | $93.33 | $97.72 | $97.72 |
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 $66.07 Median $93.33 Typical High $154.88 | Professional | None | $66.07 | $93.33 | $154.88 |
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 $33.11 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $13.18 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $9.55 | $9.55 |
Where Connecticut sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 32nd of 51
$93.33
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.