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 $4,570.88 Median $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,380.38 Typical High $3,090.30 | Professional | None | $354.81 | $1,380.38 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $14,454.40 Typical High $27,542.29 | Facility | None | $7,585.78 | $14,454.40 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,698.24 Typical High $5,011.87 | Professional | None | $602.56 | $1,698.24 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $2,511.89 Typical High $7,585.78 | Professional | 50 · Both sides | $912.01 | $2,511.89 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $3,630.78 | Professional | None | $478.63 | $812.83 | $3,630.78 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,818.38 | $4,073.80 |
Health New England Setting Facility Modifier None Typical Low $10,232.93 Median $12,589.25 Typical High $16,218.10 | Facility | None | $10,232.93 | $12,589.25 | $16,218.10 |
Health New England Setting Professional Modifier None Typical Low $794.33 Median $1,584.89 Typical High $1,659.59 | Professional | None | $794.33 | $1,584.89 | $1,659.59 |
United Setting Facility Modifier None Typical Low $7,079.46 Median $11,220.18 Typical High $18,620.87 | Facility | None | $7,079.46 | $11,220.18 | $18,620.87 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,584.89 Typical High $5,754.40 | Professional | None | $398.11 | $1,584.89 | $5,754.40 |
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 $204.17 Median $691.83 Typical High $1,548.82 | Professional | 52 · Reduced service | $204.17 | $691.83 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $275.42 Typical High $616.60 | Professional | 53 · Discontinued | $81.28 | $275.42 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,023.29 Typical High $2,344.23 | Professional | 54 · Surgery only | $302.00 | $1,023.29 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $204.17 Typical High $467.74 | Professional | 55 · Aftercare only | $60.26 | $204.17 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $138.04 Typical High $309.03 | Professional | 56 · Pre-op care only | $40.74 | $138.04 | $309.03 |
Where Connecticut sits
The same service costs 6.3 times more in Washington 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· 35th of 51
$1,660
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.