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 $2,570.40 Median $4,365.16 Typical High $7,585.78 | Facility | None | $2,570.40 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $134.90 | Professional | None | $45.71 | $79.43 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,949.84 | $3,019.95 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $316.23 | Professional | None | $74.13 | $123.03 | $316.23 |
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 $50.12 Median $123.03 Typical High $186.21 | Professional | None | $50.12 | $123.03 | $186.21 |
ConnectiCare Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $218.78 | Professional | None | $112.20 | $141.25 | $218.78 |
Health New England Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Health New England Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $251.19 | Professional | None | $91.20 | $91.20 | $251.19 |
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 $39.81 Median $102.33 Typical High $234.42 | Professional | None | $39.81 | $102.33 | $234.42 |
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 $23.44 Median $38.02 Typical High $66.07 | Professional | 52 · Reduced service | $23.44 | $38.02 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $26.30 | Professional | 53 · Discontinued | $9.55 | $15.14 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $100.00 | Professional | 54 · Surgery only | $35.48 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $19.95 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $13.18 |
Where Connecticut sits
The same service costs 3.4 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· 14th of 51
$112
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.