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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $186.21 | Professional | None | $93.33 | $134.90 | $186.21 |
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 $104.71 Median $165.96 Typical High $223.87 | Professional | None | $104.71 | $165.96 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $158.49 Typical High $1,000.00 | Facility | None | $134.90 | $158.49 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $281.84 | Professional | None | $138.04 | $169.82 | $281.84 |
ConnectiCare Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | None | $199.53 | $199.53 | $251.19 |
Health New England Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $269.15 | Professional | None | $112.20 | $263.03 | $269.15 |
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 $107.15 Median $165.96 Typical High $331.13 | Professional | None | $107.15 | $165.96 | $331.13 |
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 $54.95 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $83.18 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $15.85 |
Where Connecticut sits
The same service costs 3.7 times more in Alaska 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
$166
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.