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 $4,466.84 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $234.42 | Professional | None | $45.71 | $117.49 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,819.70 | $2,884.03 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $416.87 | Professional | None | $77.62 | $134.90 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $275.42 | Professional | None | $54.95 | $131.83 | $275.42 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $288.40 | Professional | None | $186.21 | $229.09 | $288.40 |
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 $39.81 Median $141.25 Typical High $416.87 | Professional | None | $39.81 | $141.25 | $416.87 |
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 $22.91 Median $53.70 Typical High $117.49 | Professional | 52 · Reduced service | $22.91 | $53.70 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $21.88 Typical High $46.77 | Professional | 53 · Discontinued | $9.33 | $21.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $89.13 Typical High $173.78 | Professional | 54 · Surgery only | $34.67 | $89.13 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $16.22 Typical High $34.67 | Professional | 55 · Aftercare only | $6.92 | $16.22 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.72 Typical High $23.44 | Professional | 56 · Pre-op care only | $4.57 | $10.72 | $23.44 |
Where Connecticut sits
The same service costs 4.6 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· 28th of 51
$132
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.