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 $104.71 Median $158.49 Typical High $158.49 | Professional | None | $104.71 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $234.42 | Professional | None | $104.71 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $1,380.38 | Facility | None | $489.78 | $562.34 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $223.87 | Professional | None | $128.82 | $147.91 | $223.87 |
ConnectiCare Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $165.96 | Professional | None | $104.71 | $154.88 | $165.96 |
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 $102.33 Median $151.36 Typical High $371.54 | Professional | None | $102.33 | $151.36 | $371.54 |
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 $52.48 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $15.85 |
Where Connecticut sits
The same service costs 4.8 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· 17th of 51
$158
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.