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 $104.71 Median $147.91 Typical High $199.53 | Professional | None | $104.71 | $147.91 | $199.53 |
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 $120.23 Median $199.53 Typical High $295.12 | Professional | None | $120.23 | $199.53 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $186.21 Typical High $1,000.00 | Facility | None | $158.49 | $186.21 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $338.84 | Professional | None | $162.18 | $213.80 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | None | $245.47 | $245.47 | $302.00 |
Health New England Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | None | $257.04 | $316.23 | $316.23 |
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 $123.03 Median $199.53 Typical High $380.19 | Professional | None | $123.03 | $199.53 | $380.19 |
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 $66.07 Median $74.13 Typical High $97.72 | Professional | 52 · Reduced service | $66.07 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $147.91 | Professional | 54 · Surgery only | $100.00 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $19.95 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.79 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $14.79 | $19.50 |
Where Connecticut sits
The same service costs 3.2 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
$195
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.