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 $81.28 Median $117.49 Typical High $117.49 | Professional | None | $81.28 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $181.97 | Professional | None | $70.79 | $123.03 | $181.97 |
ConnectiCare Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $234.42 | Professional | None | $79.43 | $117.49 | $234.42 |
4 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 $40.74 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $11.75 |
Where Connecticut sits
The same service costs 21.4 times more in Oklahoma than in New York. 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· 27th of 51
$123
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.