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 $77.62 Median $154.88 Typical High $338.84 | Professional | None | $77.62 | $154.88 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $436.52 | Professional | None | $112.20 | $181.97 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $371.54 | Professional | None | $107.15 | $154.88 | $371.54 |
ConnectiCare Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $354.81 | Professional | None | $204.17 | $331.13 | $354.81 |
Health New England Setting Professional Modifier None Typical Low $275.42 Median $912.01 Typical High $912.01 | Professional | None | $275.42 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $467.74 | Professional | None | $72.44 | $190.55 | $467.74 |
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 $77.62 Typical High $169.82 | Professional | 52 · Reduced service | $41.69 | $77.62 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $30.90 Typical High $67.61 | Professional | 53 · Discontinued | $16.60 | $30.90 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $114.82 Typical High $257.04 | Professional | 54 · Surgery only | $63.10 | $114.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.91 Typical High $51.29 | Professional | 55 · Aftercare only | $12.59 | $22.91 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.49 Typical High $33.88 | Professional | 56 · Pre-op care only | $8.32 | $15.49 | $33.88 |
Where Connecticut sits
The same service costs 2.7 times more in Wisconsin 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· 22nd of 51
$186
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.