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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,122.02 Typical High $1,122.02 | Professional | None | $251.19 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $194.98 | Professional | None | $72.44 | $100.00 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $4,365.16 | Facility | None | $851.14 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $1,000.00 Typical High $1,698.24 | Professional | None | $245.47 | $1,000.00 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $2,089.30 | Professional | None | $537.03 | $851.14 | $2,089.30 |
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 $125.89 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $125.89 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $50.12 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $190.55 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $38.02 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $25.12 | $112.20 | $112.20 |
Where Connecticut sits
The same service costs 53.7 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· 49th of 51
$195
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.