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 $69.18 Median $112.20 Typical High $169.82 | Professional | None | $69.18 | $112.20 | $169.82 |
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 $79.43 Median $117.49 Typical High $204.17 | Professional | None | $79.43 | $117.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $158.49 Typical High $1,000.00 | Facility | None | $134.90 | $158.49 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $251.19 | Professional | None | $81.28 | $141.25 | $251.19 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | None | $186.21 | $186.21 | $204.17 |
Health New England Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $257.04 | Professional | None | $125.89 | $257.04 | $257.04 |
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 $60.26 Median $120.23 Typical High $281.84 | Professional | None | $60.26 | $120.23 | $281.84 |
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 $45.71 Median $46.77 Typical High $81.28 | Professional | 52 · Reduced service | $45.71 | $46.77 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $33.11 | Professional | 53 · Discontinued | $18.20 | $18.62 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $123.03 | Professional | 54 · Surgery only | $69.18 | $69.18 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $24.55 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $16.60 |
Where Connecticut sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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
$132
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.