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 $54.95 Median $87.10 Typical High $87.10 | Professional | None | $54.95 | $87.10 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,818.38 Typical High $6,760.83 | Facility | None | $831.76 | $2,818.38 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $87.10 Typical High $125.89 | Professional | None | $47.86 | $87.10 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $562.34 Typical High $1,000.00 | Facility | None | $426.58 | $562.34 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $109.65 | Professional | None | $66.07 | $79.43 | $109.65 |
ConnectiCare Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $93.33 | Professional | None | $50.12 | $87.10 | $93.33 |
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 $47.86 Median $77.62 Typical High $177.83 | Professional | None | $47.86 | $77.62 | $177.83 |
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 $27.54 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $27.54 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $10.96 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $41.69 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $8.13 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $8.71 |
Where Connecticut sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 14th of 51
$87.10
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.