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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $125.89 | Professional | None | $54.95 | $72.44 | $125.89 |
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 $51.29 Median $85.11 Typical High $154.88 | Professional | None | $51.29 | $85.11 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $186.21 | Professional | None | $56.23 | $109.65 | $186.21 |
ConnectiCare Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | None | $120.23 | $120.23 | $154.88 |
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 $44.67 Median $87.10 Typical High $213.80 | Professional | None | $44.67 | $87.10 | $213.80 |
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 $27.54 Median $36.31 Typical High $63.10 | Professional | 52 · Reduced service | $27.54 | $36.31 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $25.12 | Professional | 53 · Discontinued | $11.22 | $14.45 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $54.95 Typical High $93.33 | Professional | 54 · Surgery only | $41.69 | $54.95 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.96 Typical High $18.62 | Professional | 55 · Aftercare only | $8.32 | $10.96 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $12.59 |
Where Connecticut sits
The same service costs 3.4 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· 12th of 51
$97.72
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.