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 $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
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 $457.09 Median $776.25 Typical High $1,096.48 | Professional | None | $457.09 | $776.25 | $1,096.48 |
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 $588.84 Median $758.58 Typical High $1,174.90 | Professional | None | $588.84 | $758.58 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | None | $776.25 | $776.25 | $851.14 |
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 $489.78 Median $851.14 Typical High $1,584.89 | Professional | None | $489.78 | $851.14 | $1,584.89 |
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 $257.04 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $77.62 | $77.62 |
Where Connecticut sits
The same service costs 3.9 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· 14th of 51
$851
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.