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 $4,466.84 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $134.90 | Professional | None | $39.81 | $83.18 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $186.21 | Professional | None | $43.65 | $97.72 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $120.23 Typical High $154.88 | Facility | None | $51.29 | $120.23 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $194.98 | Professional | None | $61.66 | $109.65 | $194.98 |
ConnectiCare Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | None | $141.25 | $141.25 | $158.49 |
Health New England Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | None | $104.71 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $34.67 Median $91.20 Typical High $229.09 | Professional | None | $34.67 | $91.20 | $229.09 |
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 $30.20 Median $32.36 Typical High $66.07 | Professional | 52 · Reduced service | $30.20 | $32.36 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $26.30 | Professional | 53 · Discontinued | $12.02 | $12.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $48.98 Typical High $97.72 | Professional | 54 · Surgery only | $45.71 | $48.98 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.77 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $9.77 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.46 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.03 | $6.46 | $13.18 |
Where Connecticut sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 12th of 51
$100
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.