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 $40.74 Median $57.54 Typical High $83.18 | Professional | None | $40.74 | $57.54 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $2,818.38 Typical High $7,762.47 | Facility | None | $676.08 | $2,818.38 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $123.03 | Professional | None | $43.65 | $79.43 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $1,122.02 | Facility | None | $56.23 | $67.61 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $114.82 | Professional | None | $48.98 | $81.28 | $114.82 |
ConnectiCare Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $95.50 | Professional | None | $63.10 | $85.11 | $95.50 |
Health New England Setting Facility Modifier None Typical Low $151.36 Median $588.84 Typical High $691.83 | Facility | None | $151.36 | $588.84 | $691.83 |
Health New England Setting Professional Modifier None Typical Low $23.44 Median $23.99 Typical High $100.00 | Professional | None | $23.44 | $23.99 | $100.00 |
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 $33.88 Median $66.07 Typical High $141.25 | Professional | None | $33.88 | $66.07 | $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 $25.12 Median $28.18 Typical High $40.74 | Professional | 52 · Reduced service | $25.12 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.22 Typical High $16.22 | Professional | 53 · Discontinued | $10.00 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $41.69 Typical High $61.66 | Professional | 54 · Surgery only | $37.15 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.51 Typical High $12.30 | Professional | 55 · Aftercare only | $7.41 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.62 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.01 | $5.62 | $8.13 |
Where Connecticut sits
The same service costs 4.2 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· 11th of 51
$77.62
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.