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 $114.82 Median $169.82 Typical High $169.82 | Professional | None | $114.82 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,370.32 Typical High $15,135.61 | Facility | None | $2,754.23 | $5,370.32 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $309.03 | Professional | None | $114.82 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $9,120.11 Typical High $11,220.18 | Facility | None | $549.54 | $9,120.11 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $269.15 | Professional | None | $138.04 | $165.96 | $269.15 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $208.93 | Professional | None | $141.25 | $173.78 | $208.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $407.38 | Professional | None | $104.71 | $173.78 | $407.38 |
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 $57.54 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $87.10 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $16.98 |
Where Connecticut sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 13th of 51
$200
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.