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 $4,897.79 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,897.79 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $501.19 | Professional | None | $162.18 | $245.47 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $8,912.51 | Facility | None | $1,949.84 | $3,162.28 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $524.81 | Professional | None | $186.21 | $302.00 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $501.19 Typical High $1,230.27 | Facility | None | $426.58 | $501.19 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $630.96 | Professional | None | $223.87 | $363.08 | $630.96 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Facility | None | $331.13 | $457.09 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | None | $398.11 | $398.11 | $562.34 |
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 $147.91 Median $309.03 Typical High $691.83 | Professional | None | $147.91 | $309.03 | $691.83 |
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 $83.18 Median $120.23 Typical High $251.19 | Professional | 52 · Reduced service | $83.18 | $120.23 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $100.00 | Professional | 53 · Discontinued | $33.11 | $48.98 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $181.97 Typical High $371.54 | Professional | 54 · Surgery only | $125.89 | $181.97 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $74.13 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $50.12 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $50.12 |
Where Connecticut sits
The same service costs 3.1 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· 15th of 51
$347
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.