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 $208.93 Median $302.00 Typical High $302.00 | Professional | None | $208.93 | $302.00 | $302.00 |
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 $190.55 Median $309.03 Typical High $457.09 | Professional | None | $190.55 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $371.54 Typical High $1,000.00 | Facility | None | $66.07 | $371.54 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $446.68 | Professional | None | $275.42 | $302.00 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | None | $363.08 | $371.54 | $371.54 |
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 $204.17 Median $281.84 Typical High $467.74 | Professional | None | $204.17 | $281.84 | $467.74 |
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 $104.71 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $30.20 | $30.20 |
Where Connecticut sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 14th of 51
$309
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.