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 $537.03 Median $794.33 Typical High $794.33 | Professional | None | $537.03 | $794.33 | $794.33 |
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 $478.63 Median $812.83 Typical High $1,148.15 | Professional | None | $478.63 | $812.83 | $1,148.15 |
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 $602.56 Median $794.33 Typical High $1,230.27 | Professional | None | $602.56 | $794.33 | $1,230.27 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | None | $794.33 | $794.33 | $912.01 |
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 $512.86 Median $870.96 Typical High $1,698.24 | Professional | None | $512.86 | $870.96 | $1,698.24 |
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 $269.15 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $79.43 | $79.43 |
Where Connecticut sits
The same service costs 3.8 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.