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 $85.11 Median $141.25 Typical High $194.98 | Professional | None | $85.11 | $141.25 | $194.98 |
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 $47.86 Median $66.07 Typical High $158.49 | Professional | None | $47.86 | $66.07 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $100.00 Typical High $239.88 | Professional | 50 · Both sides | $72.44 | $100.00 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $1,000.00 | Facility | None | $104.71 | $123.03 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $208.93 | Professional | None | $95.50 | $151.36 | $208.93 |
ConnectiCare Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $213.80 | Professional | None | $95.50 | $162.18 | $213.80 |
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 $41.69 Median $100.00 Typical High $234.42 | Professional | None | $41.69 | $100.00 | $234.42 |
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 $43.65 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $43.65 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $38.90 | Professional | 53 · Discontinued | $17.38 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $64.57 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $21.38 Typical High $28.84 | Professional | 55 · Aftercare only | $12.88 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.13 Typical High $19.50 | Professional | 56 · Pre-op care only | $8.71 | $14.13 | $19.50 |
Where Connecticut sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 12th of 51
$120
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.