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 Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $213.80 | Professional | None | $123.03 | $165.96 | $213.80 |
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 $120.23 Median $194.98 Typical High $269.15 | Professional | None | $120.23 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $281.84 Typical High $398.11 | Professional | 50 · Both sides | $177.83 | $281.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $151.36 Typical High $194.98 | Facility | None | $51.29 | $151.36 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $338.84 | Professional | None | $177.83 | $213.80 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $251.19 | Professional | None | $177.83 | $223.87 | $251.19 |
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 $100.00 Median $186.21 Typical High $389.05 | Professional | None | $100.00 | $186.21 | $389.05 |
4 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 $67.61 Median $83.18 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $16.60 | $21.38 |
Where Connecticut sits
The same service costs 4.3 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· 12th of 51
$200
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.