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 $245.47 Median $323.59 Typical High $363.08 | Professional | None | $245.47 | $323.59 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $562.34 | Professional | None | $257.04 | $446.68 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $912.01 Typical High $977.24 | Facility | None | $851.14 | $912.01 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $501.19 | Professional | None | $275.42 | $316.23 | $501.19 |
ConnectiCare Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $467.74 | Professional | None | $281.84 | $338.84 | $467.74 |
Health New England Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $489.78 | Professional | None | $288.40 | $467.74 | $489.78 |
United Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $645.65 | Professional | None | $234.42 | $295.12 | $645.65 |
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 $117.49 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $46.77 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $35.48 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.44 | $32.36 | $32.36 |
Where Connecticut sits
The same service costs 2.8 times more in Alaska 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· 17th of 51
$363
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.