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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $64.57 | Professional | None | $42.66 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $89.13 | Professional | None | $34.67 | $58.88 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $100.00 | Professional | None | $53.70 | $61.66 | $100.00 |
ConnectiCare Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $134.90 | Professional | None | $41.69 | $63.10 | $134.90 |
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 $21.38 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $21.38 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $8.51 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $48.98 Typical High $48.98 | Professional | 54 · Surgery only | $32.36 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $6.46 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.27 | $6.46 | $6.46 |
Where Connecticut sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 23rd of 51
$69.18
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.