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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | None | $104.71 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $2,137.96 Typical High $3,162.28 | Facility | None | $363.08 | $2,137.96 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $263.03 | Professional | None | $104.71 | $199.53 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $229.09 | Professional | None | $134.90 | $154.88 | $229.09 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $169.82 | Professional | None | $123.03 | $158.49 | $169.82 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $371.54 | Professional | None | $95.50 | $165.96 | $371.54 |
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 $52.48 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $77.62 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $15.85 |
Where Connecticut sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 11th of 51
$182
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.