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 $660.69 Median $4,365.16 Typical High $7,585.78 | Facility | None | $660.69 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $158.49 | Professional | None | $58.88 | $117.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $7,943.28 | Facility | None | $2,137.96 | $3,162.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $223.87 | Professional | None | $64.57 | $134.90 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $218.78 | Professional | None | $75.86 | $147.91 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $190.55 | Professional | None | $114.82 | $151.36 | $190.55 |
Health New England Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $43.65 Median $107.15 Typical High $257.04 | Professional | None | $43.65 | $107.15 | $257.04 |
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 $32.36 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $32.36 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $31.62 | Professional | 53 · Discontinued | $13.49 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $47.86 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $17.38 Typical High $23.99 | Professional | 55 · Aftercare only | $9.55 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $15.85 |
Where Connecticut sits
The same service costs 2.5 times more in North Carolina 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· 6th 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.