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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $851.14 Typical High $1,905.46 | Professional | None | $288.40 | $851.14 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $27,542.29 Median $27,542.29 Typical High $37,153.52 | Facility | None | $27,542.29 | $27,542.29 | $37,153.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $977.24 Typical High $2,754.23 | Professional | None | $436.52 | $977.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $2,290.87 | Professional | None | $363.08 | $524.81 | $2,290.87 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $7,079.46 | Professional | None | $1,288.25 | $1,778.28 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $295.12 Median $1,023.29 Typical High $3,162.28 | Professional | None | $295.12 | $1,023.29 | $3,162.28 |
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 $151.36 Median $426.58 Typical High $954.99 | Professional | 52 · Reduced service | $151.36 | $426.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $169.82 Typical High $380.19 | Professional | 53 · Discontinued | $61.66 | $169.82 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $630.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $229.09 | $630.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $125.89 Typical High $288.40 | Professional | 55 · Aftercare only | $45.71 | $125.89 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $30.90 | $85.11 | $190.55 |
Where Connecticut sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 28th of 51
$933
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.