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 $66.07 Median $97.72 Typical High $131.83 | Professional | None | $66.07 | $97.72 | $131.83 |
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 $83.18 Median $134.90 Typical High $194.98 | Professional | None | $83.18 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $1,000.00 | Facility | None | $117.49 | $138.04 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $229.09 | Professional | None | $102.33 | $141.25 | $229.09 |
ConnectiCare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | None | $162.18 | $162.18 | $208.93 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $257.04 | Professional | None | $79.43 | $131.83 | $257.04 |
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 $44.67 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $44.67 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $17.78 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $74.13 Typical High $97.72 | Professional | 54 · Surgery only | $66.07 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.91 | $9.77 | $13.18 |
Where Connecticut sits
The same service costs 3.6 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· 13th of 51
$135
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.