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 $4,365.16 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $645.65 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $10,000.00 Typical High $16,218.10 | Facility | None | $977.24 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,230.27 | Professional | None | $512.86 | $851.14 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,230.27 Typical High $1,862.09 | Professional | 50 · Both sides | $776.25 | $1,230.27 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,232.93 Typical High $12,589.25 | Facility | None | $851.14 | $10,232.93 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,412.54 | Professional | None | $758.58 | $870.96 | $1,412.54 |
ConnectiCare Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,778.28 | Professional | None | $549.54 | $758.58 | $1,778.28 |
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 $323.59 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Where Connecticut sits
The same service costs 3.9 times more in Alaska than in New York. 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· 15th of 51
$977
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.