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 $93.33 Median $275.42 Typical High $489.78 | Professional | None | $93.33 | $275.42 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,818.38 Typical High $7,762.47 | Facility | None | $794.33 | $2,818.38 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $912.01 | Professional | None | $173.78 | $331.13 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $1,380.38 | Facility | None | $275.42 | $323.59 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $575.44 | Professional | None | $128.82 | $190.55 | $575.44 |
ConnectiCare Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $645.65 | Professional | None | $436.52 | $524.81 | $645.65 |
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 $85.11 Median $309.03 Typical High $870.96 | Professional | None | $85.11 | $309.03 | $870.96 |
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 $47.86 Median $138.04 Typical High $245.47 | Professional | 52 · Reduced service | $47.86 | $138.04 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $54.95 Typical High $97.72 | Professional | 53 · Discontinued | $19.05 | $54.95 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $208.93 Typical High $371.54 | Professional | 54 · Surgery only | $72.44 | $208.93 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $41.69 Typical High $74.13 | Professional | 55 · Aftercare only | $14.45 | $41.69 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $27.54 Typical High $48.98 | Professional | 56 · Pre-op care only | $9.55 | $27.54 | $48.98 |
Where Connecticut sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 24th of 51
$309
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.