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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $67.61 | Professional | None | $29.51 | $40.74 | $67.61 |
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 $26.30 Median $36.31 Typical High $54.95 | Professional | None | $26.30 | $36.31 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $38.02 Typical High $1,230.27 | Facility | None | $32.36 | $38.02 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $61.66 Typical High $75.86 | Professional | None | $35.48 | $61.66 | $75.86 |
ConnectiCare Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $70.79 | Professional | None | $40.74 | $58.88 | $70.79 |
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 $22.39 Median $40.74 Typical High $89.13 | Professional | None | $22.39 | $40.74 | $89.13 |
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 $15.85 Median $20.42 Typical High $33.88 | Professional | 52 · Reduced service | $15.85 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.32 Typical High $13.49 | Professional | 53 · Discontinued | $6.31 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $30.90 Typical High $50.12 | Professional | 54 · Surgery only | $23.99 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.17 Typical High $10.00 | Professional | 55 · Aftercare only | $4.79 | $6.17 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.07 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.16 | $4.07 | $6.76 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$40.74
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.