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 $2,754.23 Median $4,365.16 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $181.97 | Professional | None | $53.70 | $107.15 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,949.84 | $3,162.28 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $363.08 | Professional | None | $83.18 | $138.04 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $275.42 Typical High $1,000.00 | Facility | None | $234.42 | $275.42 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $114.82 Typical High $218.78 | Professional | None | $39.81 | $114.82 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $12.30 Median $154.88 Typical High $245.47 | Professional | None | $12.30 | $154.88 | $245.47 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $46.77 Median $131.83 Typical High $331.13 | Professional | None | $46.77 | $131.83 | $331.13 |
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 $27.54 Median $50.12 Typical High $91.20 | Professional | 52 · Reduced service | $27.54 | $50.12 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $19.95 Typical High $37.15 | Professional | 53 · Discontinued | $11.22 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $74.13 Typical High $138.04 | Professional | 54 · Surgery only | $41.69 | $74.13 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $15.14 Typical High $27.54 | Professional | 55 · Aftercare only | $8.32 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $10.00 Typical High $18.62 | Professional | 56 · Pre-op care only | $5.62 | $10.00 | $18.62 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska 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· 21st 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.