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 $407.38 Median $1,659.59 Typical High $3,630.78 | Professional | None | $407.38 | $1,659.59 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $14,125.38 Typical High $16,595.87 | Facility | None | $7,585.78 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,949.84 Typical High $4,786.30 | Professional | None | $537.03 | $1,949.84 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $4,365.16 | Professional | None | $549.54 | $812.83 | $4,365.16 |
ConnectiCare Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,290.87 | $3,162.28 | $3,801.89 |
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 $389.05 Median $1,862.09 Typical High $6,309.57 | Professional | None | $389.05 | $1,862.09 | $6,309.57 |
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 $831.76 Typical High $1,819.70 | Professional | 52 · Reduced service | $204.17 | $831.76 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $331.13 Typical High $724.44 | Professional | 53 · Discontinued | $81.28 | $331.13 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,230.27 Typical High $2,691.53 | Professional | 54 · Surgery only | $309.03 | $1,230.27 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $245.47 Typical High $549.54 | Professional | 55 · Aftercare only | $61.66 | $245.47 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $165.96 Typical High $363.08 | Professional | 56 · Pre-op care only | $40.74 | $165.96 | $363.08 |
Where Connecticut sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 24th of 51
$1,950
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.