How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $100.00 | Professional | None | $67.61 | $97.72 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $162.18 | Professional | None | $61.66 | $87.10 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $1,000.00 Typical High $2,570.40 | Facility | None | $190.55 | $1,000.00 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $141.25 | Professional | None | $85.11 | $97.72 | $141.25 |
ConnectiCare Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $117.49 | Professional | None | $77.62 | $104.71 | $117.49 |
Health New England Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $181.97 | Professional | None | $70.79 | $91.20 | $181.97 |
4 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 $33.11 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $33.11 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $13.18 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $10.00 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.61 | $9.77 | $9.77 |
Where Connecticut sits
The same service costs 3.2 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· 16th of 51
$93.33
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.