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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $204.17 | Professional | None | $66.07 | $107.15 | $204.17 |
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 $64.57 Median $100.00 Typical High $138.04 | Professional | None | $64.57 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $1,000.00 | Facility | None | $165.96 | $190.55 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $257.04 | Professional | None | $89.13 | $141.25 | $257.04 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | None | $186.21 | $186.21 | $223.87 |
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 $128.82 Typical High $281.84 | Professional | None | $61.66 | $128.82 | $281.84 |
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 $34.67 Median $53.70 Typical High $102.33 | Professional | 52 · Reduced service | $34.67 | $53.70 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.38 Typical High $40.74 | Professional | 53 · Discontinued | $13.80 | $21.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $79.43 Typical High $154.88 | Professional | 54 · Surgery only | $52.48 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.85 Typical High $30.90 | Professional | 55 · Aftercare only | $10.47 | $15.85 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.72 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.92 | $10.72 | $20.42 |
Where Connecticut sits
The same service costs 3.9 times more in Wisconsin 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· 21st of 51
$120
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.