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 $912.01 Median $4,365.16 Typical High $7,585.78 | Facility | None | $912.01 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $213.80 | Professional | None | $85.11 | $131.83 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $190.55 Typical High $316.23 | Professional | 50 · Both sides | $128.82 | $190.55 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $147.91 Typical High $851.14 | Facility | None | $66.07 | $147.91 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $208.93 | Professional | None | $97.72 | $144.54 | $208.93 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $165.96 | Professional | None | $123.03 | $128.82 | $165.96 |
Health New England Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $275.42 | Professional | None | $186.21 | $229.09 | $275.42 |
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 $52.48 Median $109.65 Typical High $245.47 | Professional | None | $52.48 | $109.65 | $245.47 |
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 $44.67 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $44.67 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $26.92 | Professional | 53 · Discontinued | $17.78 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $67.61 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $13.49 |
Where Connecticut sits
The same service costs 3.7 times more in Alaska 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· 8th of 51
$135
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.