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 $128.82 Median $208.93 Typical High $208.93 | Professional | None | $128.82 | $208.93 | $208.93 |
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 $123.03 Median $213.80 Typical High $275.42 | Professional | None | $123.03 | $213.80 | $275.42 |
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 $154.88 Median $199.53 Typical High $281.84 | Professional | None | $154.88 | $199.53 | $281.84 |
ConnectiCare Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $199.53 | Professional | None | $144.54 | $181.97 | $199.53 |
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 $120.23 Median $194.98 Typical High $446.68 | Professional | None | $120.23 | $194.98 | $446.68 |
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 $67.61 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $67.61 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $26.92 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.49 | $20.89 | $20.89 |
Where Connecticut sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$204
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.