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 $70.79 Median $123.03 Typical High $199.53 | Professional | None | $70.79 | $123.03 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $363.08 | Professional | None | $104.71 | $162.18 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $446.68 | Professional | None | $87.10 | $134.90 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $363.08 | Professional | None | $173.78 | $194.98 | $363.08 |
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 $66.07 Median $165.96 Typical High $537.03 | Professional | None | $66.07 | $165.96 | $537.03 |
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 $35.48 Median $56.23 Typical High $100.00 | Professional | 52 · Reduced service | $35.48 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.39 Typical High $39.81 | Professional | 53 · Discontinued | $14.13 | $22.39 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $83.18 Typical High $151.36 | Professional | 54 · Surgery only | $53.70 | $83.18 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.60 Typical High $30.20 | Professional | 55 · Aftercare only | $10.72 | $16.60 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $19.95 |
Where Connecticut sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 15th of 51
$162
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.