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 $74.13 Median $125.89 Typical High $177.83 | Professional | None | $74.13 | $125.89 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $7,943.28 | Facility | None | $4,786.30 | $5,888.44 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $257.04 | Professional | None | $89.13 | $158.49 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $354.81 | Professional | None | $79.43 | $134.90 | $354.81 |
ConnectiCare Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $288.40 | Professional | None | $134.90 | $154.88 | $288.40 |
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 $72.44 Median $138.04 Typical High $338.84 | Professional | None | $72.44 | $138.04 | $338.84 |
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 $40.74 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $40.74 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $16.22 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $61.66 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $12.30 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $17.78 |
Where Connecticut sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 13th of 51
$145
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.