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 $63.10 Median $95.50 Typical High $147.91 | Professional | None | $63.10 | $95.50 | $147.91 |
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 $67.61 Median $109.65 Typical High $177.83 | Professional | None | $67.61 | $109.65 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $758.58 Typical High $1,659.59 | Facility | None | $426.58 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $213.80 | Professional | None | $74.13 | $125.89 | $213.80 |
ConnectiCare Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | None | $138.04 | $138.04 | $177.83 |
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 $58.88 Median $102.33 Typical High $251.19 | Professional | None | $58.88 | $102.33 | $251.19 |
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 $36.31 Median $47.86 Typical High $72.44 | Professional | 52 · Reduced service | $36.31 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.05 Typical High $29.51 | Professional | 53 · Discontinued | $14.79 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $72.44 Typical High $109.65 | Professional | 54 · Surgery only | $54.95 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $21.88 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.55 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.24 | $9.55 | $14.79 |
Where Connecticut sits
The same service costs 3.5 times more in Wisconsin 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· 13th of 51
$120
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.