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 $125.89 Median $181.97 Typical High $204.17 | Professional | None | $125.89 | $181.97 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $25,703.96 Typical High $34,673.69 | Facility | None | $10,000.00 | $25,703.96 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $275.42 | Professional | None | $107.15 | $141.25 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $14,454.40 | Facility | None | $501.19 | $1,000.00 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $269.15 | Professional | None | $144.54 | $165.96 | $269.15 |
ConnectiCare Setting Facility Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $4,786.30 | Facility | None | $3,981.07 | $4,677.35 | $4,786.30 |
ConnectiCare Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $309.03 | Professional | None | $151.36 | $213.80 | $309.03 |
Health New England Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,709.64 | Facility | None | $8,128.31 | $8,128.31 | $8,709.64 |
Health New England Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $1,949.84 | Professional | None | $177.83 | $177.83 | $1,949.84 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,621.81 Typical High $4,466.84 | Facility | None | $251.19 | $1,621.81 | $4,466.84 |
United Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $323.59 | Professional | None | $93.33 | $173.78 | $323.59 |
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 $63.10 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $63.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $25.12 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $19.05 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.59 | $18.20 | $18.20 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 25th of 51
$158
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.