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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $123.03 | Professional | None | $60.26 | $85.11 | $123.03 |
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 $67.61 Median $120.23 Typical High $177.83 | Professional | None | $67.61 | $120.23 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $117.49 Typical High $1,000.00 | Facility | None | $102.33 | $117.49 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $199.53 | Professional | None | $93.33 | $138.04 | $199.53 |
ConnectiCare Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | None | $158.49 | $158.49 | $186.21 |
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 $70.79 Median $120.23 Typical High $234.42 | Professional | None | $70.79 | $120.23 | $234.42 |
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 $39.81 Median $41.69 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $25.12 | Professional | 53 · Discontinued | $15.85 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $63.10 Typical High $93.33 | Professional | 54 · Surgery only | $60.26 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $12.30 |
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· 13th of 51
$120
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.