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 $47.86 Median $72.44 Typical High $112.20 | Professional | None | $47.86 | $72.44 | $112.20 |
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 $52.48 Median $77.62 Typical High $169.82 | Professional | None | $52.48 | $77.62 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $100.00 | Facility | None | $50.12 | $79.43 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $162.18 | Professional | None | $74.13 | $112.20 | $162.18 |
ConnectiCare Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Health New England Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $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 $56.23 Median $95.50 Typical High $199.53 | Professional | None | $56.23 | $95.50 | $199.53 |
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 $32.36 Median $33.88 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $22.39 | Professional | 53 · Discontinued | $12.88 | $13.49 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $50.12 Typical High $83.18 | Professional | 54 · Surgery only | $48.98 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $11.22 |
Where Connecticut sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 17th of 51
$91.20
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.