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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $117.49 | Professional | None | $61.66 | $85.11 | $117.49 |
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 $60.26 Median $85.11 Typical High $131.83 | Professional | None | $60.26 | $85.11 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $125.89 Typical High $194.98 | Professional | 50 · Both sides | $91.20 | $125.89 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $147.91 | Professional | None | $45.71 | $89.13 | $147.91 |
ConnectiCare Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $128.82 | Professional | None | $48.98 | $81.28 | $128.82 |
Health New England Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Health New England Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $125.89 | Professional | None | $95.50 | $117.49 | $125.89 |
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 $52.48 Median $81.28 Typical High $213.80 | Professional | None | $52.48 | $81.28 | $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 $41.69 Typical High $53.70 | Professional | 52 · Reduced service | $37.15 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $16.60 Typical High $21.38 | Professional | 53 · Discontinued | $14.79 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $61.66 Typical High $79.43 | Professional | 54 · Surgery only | $54.95 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.30 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.32 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $8.32 | $10.72 |
Where Connecticut sits
The same service costs 3.6 times more in Alaska than in Florida. 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· 18th of 51
$85.11
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.