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 $28.84 Median $38.02 Typical High $46.77 | Professional | None | $28.84 | $38.02 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $229.09 | Professional | None | $16.98 | $19.95 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $1,380.38 | Facility | None | $275.42 | $323.59 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $114.82 | Professional | None | $53.70 | $100.00 | $114.82 |
ConnectiCare Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $22.91 Median $38.02 Typical High $79.43 | Professional | None | $22.91 | $38.02 | $79.43 |
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 $14.45 Median $19.05 Typical High $23.44 | Professional | 52 · Reduced service | $14.45 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.59 Typical High $9.33 | Professional | 53 · Discontinued | $5.89 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 54 · Surgery only | $21.88 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.75 Typical High $6.92 | Professional | 55 · Aftercare only | $4.37 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.80 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.95 | $3.80 | $4.68 |
Where Connecticut sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 50th of 51
$38.02
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.