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 $40.74 Median $97.72 Typical High $223.87 | Professional | None | $40.74 | $97.72 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $128.82 Typical High $426.58 | Professional | None | $66.07 | $128.82 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $309.03 | Professional | None | $60.26 | $77.62 | $309.03 |
ConnectiCare Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $346.74 | Professional | None | $204.17 | $208.93 | $346.74 |
Health New England Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $39.81 Median $138.04 Typical High $467.74 | Professional | None | $39.81 | $138.04 | $467.74 |
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 $21.88 Median $58.88 Typical High $109.65 | Professional | 52 · Reduced service | $21.88 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $23.44 Typical High $43.65 | Professional | 53 · Discontinued | $8.71 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $87.10 Typical High $162.18 | Professional | 54 · Surgery only | $32.36 | $87.10 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $17.38 Typical High $32.36 | Professional | 55 · Aftercare only | $6.46 | $17.38 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $4.37 | $11.75 | $21.88 |
Where Connecticut sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 33rd of 51
$129
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.