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 $77.62 Median $134.90 Typical High $190.55 | Professional | None | $77.62 | $134.90 | $190.55 |
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 $102.33 Median $169.82 Typical High $288.40 | Professional | None | $102.33 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $1,000.00 | Facility | None | $208.93 | $245.47 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $338.84 | Professional | None | $97.72 | $204.17 | $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 $245.47 Median $323.59 Typical High $323.59 | Professional | None | $245.47 | $323.59 | $323.59 |
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 $85.11 Median $181.97 Typical High $380.19 | Professional | None | $85.11 | $181.97 | $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 $52.48 Median $54.95 Typical High $93.33 | Professional | 52 · Reduced service | $52.48 | $54.95 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.88 Typical High $37.15 | Professional | 53 · Discontinued | $20.89 | $21.88 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $141.25 | Professional | 54 · Surgery only | $79.43 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $28.18 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $18.62 |
Where Connecticut sits
The same service costs 3.3 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· 12th of 51
$186
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.