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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $165.96 | Professional | None | $74.13 | $107.15 | $165.96 |
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 $57.54 Median $79.43 Typical High $134.90 | Professional | None | $57.54 | $79.43 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $117.49 Typical High $204.17 | Professional | 50 · Both sides | $85.11 | $117.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $1,000.00 | Facility | None | $83.18 | $97.72 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $199.53 | Professional | None | $97.72 | $154.88 | $199.53 |
ConnectiCare Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $194.98 | Professional | None | $93.33 | $151.36 | $194.98 |
Health New England Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Facility | None | $575.44 | $575.44 | $602.56 |
Health New England Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $117.49 | Professional | None | $104.71 | $109.65 | $117.49 |
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 $48.98 Median $100.00 Typical High $213.80 | Professional | None | $48.98 | $100.00 | $213.80 |
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 $37.15 Median $52.48 Typical High $83.18 | Professional | 52 · Reduced service | $37.15 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $33.11 | Professional | 53 · Discontinued | $14.79 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $77.62 Typical High $125.89 | Professional | 54 · Surgery only | $56.23 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $25.12 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $16.60 |
Where Connecticut sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 15th of 51
$105
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.