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 $95.50 Median $316.23 Typical High $501.19 | Professional | None | $95.50 | $316.23 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $11,748.98 Typical High $13,803.84 | Facility | None | $6,760.83 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $977.24 | Professional | None | $125.89 | $295.12 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $707.95 | Professional | None | $131.83 | $199.53 | $707.95 |
ConnectiCare Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $831.76 | Professional | None | $478.63 | $602.56 | $831.76 |
Health New England Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $8,709.64 Typical High $12,882.50 | Facility | None | $5,754.40 | $8,709.64 | $12,882.50 |
United Setting Professional Modifier None Typical Low $75.86 Median $302.00 Typical High $1,202.26 | Professional | None | $75.86 | $302.00 | $1,202.26 |
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 $234.42 | Professional | 52 · Reduced service | $47.86 | $138.04 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $56.23 Typical High $93.33 | Professional | 53 · Discontinued | $19.05 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $208.93 Typical High $346.74 | Professional | 54 · Surgery only | $70.79 | $208.93 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $41.69 Typical High $70.79 | Professional | 55 · Aftercare only | $14.13 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $27.54 Typical High $46.77 | Professional | 56 · Pre-op care only | $9.55 | $27.54 | $46.77 |
Where Connecticut sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 38th of 51
$316
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.