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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $109.65 | Professional | None | $83.18 | $85.11 | $109.65 |
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 $81.28 Median $123.03 Typical High $169.82 | Professional | None | $81.28 | $123.03 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $165.96 Typical High $213.80 | Facility | None | $51.29 | $165.96 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $218.78 | Professional | None | $85.11 | $131.83 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $165.96 | Professional | None | $131.83 | $138.04 | $165.96 |
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 $61.66 Median $117.49 Typical High $263.03 | Professional | None | $61.66 | $117.49 | $263.03 |
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 $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $41.69 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $16.98 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $64.57 Typical High $83.18 | Professional | 54 · Surgery only | $63.10 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $10.96 |
Where Connecticut sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 17th of 51
$117
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.