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 $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | None | $812.83 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,819.70 | Professional | None | $707.95 | $1,288.25 | $1,819.70 |
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 $912.01 Median $1,230.27 Typical High $1,949.84 | Professional | None | $912.01 | $1,230.27 | $1,949.84 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
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 $812.83 Median $1,318.26 Typical High $2,691.53 | Professional | None | $812.83 | $1,318.26 | $2,691.53 |
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 $416.87 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $416.87 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $165.96 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $630.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $83.18 | $128.82 | $128.82 |
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· 13th of 51
$1,288
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.