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 $125.89 Median $181.97 Typical High $229.09 | Professional | None | $125.89 | $181.97 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Professional | None | $144.54 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $1,000.00 | Facility | None | $190.55 | $223.87 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $398.11 | Professional | None | $194.98 | $251.19 | $398.11 |
ConnectiCare Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | None | $281.84 | $281.84 | $363.08 |
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 $147.91 Median $234.42 Typical High $457.09 | Professional | None | $147.91 | $234.42 | $457.09 |
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 $77.62 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $77.62 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $22.91 |
Where Connecticut sits
The same service costs 3.7 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· 17th of 51
$234
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.