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 $2,754.23 Median $4,466.84 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $245.47 | Professional | None | $83.18 | $162.18 | $245.47 |
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 $95.50 Median $144.54 Typical High $213.80 | Professional | None | $95.50 | $144.54 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $199.53 Typical High $323.59 | Professional | 50 · Both sides | $141.25 | $199.53 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,000.00 | Facility | None | $50.12 | $66.07 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $245.47 Typical High $389.05 | Professional | None | $97.72 | $245.47 | $389.05 |
ConnectiCare Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $478.63 | Professional | None | $275.42 | $398.11 | $478.63 |
Health New England Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $3,715.35 | Facility | None | $1,258.93 | $2,290.87 | $3,715.35 |
Health New England Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | None | $194.98 | $194.98 | $398.11 |
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 $70.79 Median $186.21 Typical High $436.52 | Professional | None | $70.79 | $186.21 | $436.52 |
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 $61.66 Median $74.13 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $47.86 | Professional | 53 · Discontinued | $24.55 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $23.99 |
Where Connecticut sits
The same service costs 3.9 times more in Alaska 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· 25th of 51
$162
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.