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 Professional Modifier None Typical Low $10.23 Median $23.44 Typical High $42.66 | Professional | None | $10.23 | $23.44 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $10,232.93 | Facility | None | $7,762.47 | $7,762.47 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $28.18 Typical High $67.61 | Professional | None | $12.02 | $28.18 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $2,691.53 | Facility | None | $501.19 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $36.31 Typical High $69.18 | Professional | None | $12.59 | $36.31 | $69.18 |
ConnectiCare Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $63.10 | Professional | None | $25.70 | $25.70 | $63.10 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $10.47 Median $29.51 Typical High $77.62 | Professional | None | $10.47 | $29.51 | $77.62 |
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 $6.92 Median $8.32 Typical High $20.89 | Professional | 52 · Reduced service | $6.92 | $8.32 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.31 Typical High $8.32 | Professional | 53 · Discontinued | $2.75 | $3.31 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $12.59 Typical High $31.62 | Professional | 54 · Surgery only | $10.47 | $12.59 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.51 Typical High $6.31 | Professional | 55 · Aftercare only | $2.09 | $2.51 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.66 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.38 | $1.66 | $4.17 |
Where Connecticut sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 23rd of 51
$31.62
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.