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 Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $66.07 | Professional | None | $30.20 | $41.69 | $66.07 |
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 $33.11 Median $64.57 Typical High $102.33 | Professional | None | $33.11 | $64.57 | $102.33 |
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 $46.77 Median $72.44 Typical High $128.82 | Professional | None | $46.77 | $72.44 | $128.82 |
ConnectiCare Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
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 $33.11 Median $69.18 Typical High $141.25 | Professional | None | $33.11 | $69.18 | $141.25 |
4 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 $20.42 Median $20.89 Typical High $33.11 | Professional | 52 · Reduced service | $20.42 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $13.18 | Professional | 53 · Discontinued | $8.13 | $8.32 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $9.77 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $6.61 |
Where Connecticut sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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
$66.07
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.