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 $3,890.45 Median $5,370.32 Typical High $10,471.29 | Facility | None | $3,890.45 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $912.01 Typical High $1,995.26 | Professional | None | $309.03 | $912.01 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $12,302.69 Typical High $27,542.29 | Facility | None | $6,760.83 | $12,302.69 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,202.26 Typical High $2,884.03 | Professional | None | $457.09 | $1,202.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $1,737.80 Typical High $4,365.16 | Professional | 50 · Both sides | $676.08 | $1,737.80 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $2,754.23 | Professional | None | $407.38 | $645.65 | $2,754.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,949.84 | $3,162.28 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $8,709.64 Typical High $12,882.50 | Facility | None | $5,754.40 | $8,709.64 | $12,882.50 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,122.02 Typical High $3,467.37 | Professional | None | $316.23 | $1,122.02 | $3,467.37 |
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 $165.96 Median $457.09 Typical High $1,000.00 | Professional | 52 · Reduced service | $165.96 | $457.09 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $181.97 Typical High $398.11 | Professional | 53 · Discontinued | $66.07 | $181.97 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $676.08 Typical High $1,479.11 | Professional | 54 · Surgery only | $245.47 | $676.08 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $138.04 Typical High $295.12 | Professional | 55 · Aftercare only | $48.98 | $138.04 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $91.20 Typical High $199.53 | Professional | 56 · Pre-op care only | $33.11 | $91.20 | $199.53 |
Where Connecticut sits
The same service costs 5.1 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· 26th of 51
$1,202
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.