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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | None | $128.82 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $281.84 | Professional | None | $120.23 | $194.98 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,715.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $295.12 | Professional | None | $190.55 | $223.87 | $295.12 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | None | $239.88 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $309.03 | Professional | None | $131.83 | $186.21 | $309.03 |
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 $69.18 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $27.54 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $19.95 |
Where Connecticut sits
The same service costs 10.7 times more in Oklahoma than in New York. 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· 28th of 51
$209
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.