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 Professional Modifier None Typical Low $16.60 Median $27.54 Typical High $50.12 | Professional | None | $16.60 | $27.54 | $50.12 |
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 $11.48 Median $26.92 Typical High $58.88 | Professional | None | $11.48 | $26.92 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,000.00 | Facility | None | $50.12 | $66.07 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $42.66 Typical High $60.26 | Professional | None | $23.44 | $42.66 | $60.26 |
ConnectiCare Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Health New England Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $42.66 | Facility | None | $20.89 | $20.89 | $42.66 |
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 $16.98 Median $37.15 Typical High $85.11 | Professional | None | $16.98 | $37.15 | $85.11 |
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 $10.00 Median $12.30 Typical High $25.12 | Professional | 52 · Reduced service | $10.00 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.90 Typical High $10.23 | Professional | 53 · Discontinued | $3.98 | $4.90 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $18.20 Typical High $38.02 | Professional | 54 · Surgery only | $14.79 | $18.20 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.63 Typical High $7.59 | Professional | 55 · Aftercare only | $3.02 | $3.63 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.45 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.00 | $2.45 | $5.13 |
Where Connecticut sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 30th of 51
$33.88
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.