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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $141.25 | Professional | None | $61.66 | $91.20 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $10,232.93 | Facility | None | $7,762.47 | $7,762.47 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $208.93 | Professional | None | $67.61 | $120.23 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $2,691.53 | Facility | None | $501.19 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $302.00 | Professional | None | $85.11 | $117.49 | $302.00 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | None | $169.82 | $169.82 | $173.78 |
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 $61.66 Median $120.23 Typical High $234.42 | Professional | None | $61.66 | $120.23 | $234.42 |
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 $41.69 Median $45.71 Typical High $70.79 | Professional | 52 · Reduced service | $41.69 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $28.18 | Professional | 53 · Discontinued | $16.60 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $67.61 Typical High $104.71 | Professional | 54 · Surgery only | $61.66 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $20.89 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $14.13 |
Where Connecticut sits
The same service costs 3.7 times more in Wisconsin 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· 11th of 51
$132
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.