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 $141.25 Median $218.78 Typical High $218.78 | Professional | None | $141.25 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $7,079.46 | Facility | None | $2,754.23 | $4,168.69 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $281.84 | Professional | None | $123.03 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,265.80 | Facility | None | $501.19 | $1,000.00 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $309.03 | Professional | None | $181.97 | $204.17 | $309.03 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | None | $218.78 | $218.78 | $234.42 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $426.58 | Professional | None | $120.23 | $186.21 | $426.58 |
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 $70.79 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $21.88 |
Where Connecticut sits
The same service costs 3.9 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· 23rd of 51
$200
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.