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 $75.86 Median $114.82 Typical High $114.82 | Professional | None | $75.86 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $169.82 | Professional | None | $70.79 | $97.72 | $169.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $141.25 Typical High $251.19 | Professional | 50 · Both sides | $104.71 | $141.25 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $3,162.28 | Facility | None | $549.54 | $2,570.40 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $186.21 | Professional | None | $104.71 | $109.65 | $186.21 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $194.98 | Professional | None | $69.18 | $93.33 | $194.98 |
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 $38.02 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $15.14 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $57.54 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $11.48 |
Where Connecticut sits
The same service costs 11.2 times more in Tennessee 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· 33rd of 51
$112
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.