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 $912.01 Median $4,365.16 Typical High $7,585.78 | Facility | None | $912.01 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $269.15 | Professional | None | $141.25 | $199.53 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $245.47 | Professional | None | $128.82 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $263.03 Typical High $512.86 | Facility | None | $51.29 | $263.03 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $389.05 | Professional | None | $186.21 | $257.04 | $389.05 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $295.12 | Professional | None | $169.82 | $223.87 | $295.12 |
Health New England Setting Professional Modifier None Typical Low $398.11 Median $776.25 Typical High $776.25 | Professional | None | $398.11 | $776.25 | $776.25 |
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 $104.71 Median $194.98 Typical High $501.19 | Professional | None | $104.71 | $194.98 | $501.19 |
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 $81.28 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $81.28 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $123.03 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $26.92 |
Where Connecticut sits
The same service costs 3.3 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· 19th of 51
$204
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.