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 $30.90 Median $79.43 Typical High $87.10 | Professional | None | $30.90 | $79.43 | $87.10 |
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 $19.95 Median $38.90 Typical High $120.23 | Professional | None | $19.95 | $38.90 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $30.20 Median $57.54 Typical High $177.83 | Professional | 50 · Both sides | $30.20 | $57.54 | $177.83 |
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 $32.36 Median $69.18 Typical High $89.13 | Professional | None | $32.36 | $69.18 | $89.13 |
ConnectiCare Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $95.50 | Professional | None | $13.80 | $22.91 | $95.50 |
Health New England Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $141.25 | Professional | None | $46.77 | $47.86 | $141.25 |
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 $24.55 Median $40.74 Typical High $128.82 | Professional | None | $24.55 | $40.74 | $128.82 |
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 $26.92 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $26.92 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $10.72 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $63.10 | Professional | 54 · Surgery only | $39.81 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $8.13 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $8.51 |
Where Connecticut sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 10th of 51
$53.70
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.