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 $1,023.29 Typical High $2,238.72 | Professional | None | $288.40 | $1,023.29 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $11,748.98 Typical High $13,803.84 | Facility | None | $6,760.83 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $3,090.30 | Professional | None | $398.11 | $1,230.27 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $2,818.38 | Professional | None | $389.05 | $588.84 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,479.11 | $2,041.74 | $2,454.71 |
Health New England Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $288.40 Median $1,202.26 Typical High $3,981.07 | Professional | None | $288.40 | $1,202.26 | $3,981.07 |
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 $158.49 Median $512.86 Typical High $1,122.02 | Professional | 52 · Reduced service | $158.49 | $512.86 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $204.17 Typical High $457.09 | Professional | 53 · Discontinued | $63.10 | $204.17 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $776.25 Typical High $1,698.24 | Professional | 54 · Surgery only | $234.42 | $776.25 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $154.88 Typical High $338.84 | Professional | 55 · Aftercare only | $46.77 | $154.88 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $102.33 Typical High $223.87 | Professional | 56 · Pre-op care only | $31.62 | $102.33 | $223.87 |
Where Connecticut sits
The same service costs 4.7 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· 30th of 51
$1,230
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.