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 $257.04 Median $389.05 Typical High $389.05 | Professional | None | $257.04 | $389.05 | $389.05 |
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 $229.09 Median $389.05 Typical High $549.54 | Professional | None | $229.09 | $389.05 | $549.54 |
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 $295.12 Median $380.19 Typical High $588.84 | Professional | None | $295.12 | $380.19 | $588.84 |
ConnectiCare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | None | $389.05 | $389.05 | $436.52 |
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 $245.47 Median $426.58 Typical High $794.33 | Professional | None | $245.47 | $426.58 | $794.33 |
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 $128.82 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $128.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $51.29 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.70 | $38.90 | $38.90 |
Where Connecticut sits
The same service costs 4.0 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· 16th of 51
$447
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.