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 $63.10 Median $89.13 Typical High $141.25 | Professional | None | $63.10 | $89.13 | $141.25 |
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 $46.77 Median $64.57 Typical High $151.36 | Professional | None | $46.77 | $64.57 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $97.72 Typical High $229.09 | Professional | 50 · Both sides | $70.79 | $97.72 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $1,148.15 | Facility | None | $107.15 | $128.82 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $177.83 | Professional | None | $72.44 | $125.89 | $177.83 |
ConnectiCare Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
ConnectiCare Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $177.83 | Professional | None | $100.00 | $138.04 | $177.83 |
Health New England Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,230.27 | Facility | None | $707.95 | $724.44 | $1,230.27 |
Health New England Setting Professional Modifier None Typical Low $44.67 Median $87.10 Typical High $194.98 | Professional | None | $44.67 | $87.10 | $194.98 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $208.93 | Professional | None | $38.02 | $91.20 | $208.93 |
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 $37.15 Typical High $66.07 | Professional | 52 · Reduced service | $37.15 | $37.15 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $26.30 | Professional | 53 · Discontinued | $14.79 | $14.79 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $97.72 | Professional | 54 · Surgery only | $54.95 | $54.95 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $19.50 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $13.18 |
Where Connecticut sits
The same service costs 3.5 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· 20th of 51
$89.13
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.