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 $81.28 Median $208.93 Typical High $363.08 | Professional | None | $81.28 | $208.93 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $234.42 | Professional | None | $102.33 | $141.25 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $208.93 Typical High $354.81 | Professional | 50 · Both sides | $151.36 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $691.83 | Professional | None | $112.20 | $186.21 | $691.83 |
ConnectiCare Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $812.83 | Professional | None | $346.74 | $426.58 | $812.83 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $89.13 Median $263.03 Typical High $776.25 | Professional | None | $89.13 | $263.03 | $776.25 |
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 $41.69 Median $87.10 Typical High $181.97 | Professional | 52 · Reduced service | $41.69 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $35.48 Typical High $74.13 | Professional | 53 · Discontinued | $16.60 | $35.48 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $131.83 Typical High $275.42 | Professional | 54 · Surgery only | $63.10 | $131.83 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $26.30 Typical High $54.95 | Professional | 55 · Aftercare only | $12.59 | $26.30 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $17.38 Typical High $36.31 | Professional | 56 · Pre-op care only | $8.32 | $17.38 | $36.31 |
Where Connecticut sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 41st of 51
$182
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.