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 Facility Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $204.17 | Professional | None | $64.57 | $112.20 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $151.36 Typical High $309.03 | Professional | None | $72.44 | $151.36 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $724.44 | Facility | None | $239.88 | $407.38 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $275.42 | Professional | None | $95.50 | $181.97 | $275.42 |
ConnectiCare Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $302.00 | Professional | None | $181.97 | $229.09 | $302.00 |
United Setting Professional Modifier None Typical Low $70.79 Median $158.49 Typical High $354.81 | Professional | None | $70.79 | $158.49 | $354.81 |
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 $32.36 Median $56.23 Typical High $102.33 | Professional | 52 · Reduced service | $32.36 | $56.23 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $22.91 Typical High $40.74 | Professional | 53 · Discontinued | $12.88 | $22.91 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $85.11 Typical High $154.88 | Professional | 54 · Surgery only | $47.86 | $85.11 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.98 Typical High $30.90 | Professional | 55 · Aftercare only | $9.77 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.46 | $11.22 | $20.42 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 13th of 51
$158
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.