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 $204.17 Median $302.00 Typical High $302.00 | Professional | None | $204.17 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $436.52 | Professional | None | $177.83 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $457.09 | Professional | None | $229.09 | $302.00 | $457.09 |
ConnectiCare Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | None | $309.03 | $309.03 | $338.84 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $630.96 | Professional | None | $194.98 | $331.13 | $630.96 |
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 $102.33 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $30.20 |
Where Connecticut sits
The same service costs 4.3 times more in Wisconsin than in New York. 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
$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.