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 $33.88 Median $60.26 Typical High $158.49 | Professional | None | $33.88 | $60.26 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $302.00 | Professional | None | $51.29 | $93.33 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $190.55 Typical High $338.84 | Facility | None | $51.29 | $190.55 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $128.82 Typical High $234.42 | Professional | None | $47.86 | $128.82 | $234.42 |
ConnectiCare Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | None | $173.78 | $173.78 | $204.17 |
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 $33.88 Median $97.72 Typical High $302.00 | Professional | None | $33.88 | $97.72 | $302.00 |
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 $19.95 Median $30.20 Typical High $79.43 | Professional | 52 · Reduced service | $19.95 | $30.20 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.02 Typical High $31.62 | Professional | 53 · Discontinued | $7.94 | $12.02 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $44.67 Typical High $120.23 | Professional | 54 · Surgery only | $30.20 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.91 Typical High $23.99 | Professional | 55 · Aftercare only | $6.03 | $8.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.03 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.98 | $6.03 | $15.85 |
Where Connecticut sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 20th of 51
$110
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.