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 $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 $169.82 Median $263.03 Typical High $263.03 | Professional | None | $169.82 | $263.03 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $416.87 | Professional | None | $173.78 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $891.25 | Facility | None | $501.19 | $758.58 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $501.19 | Professional | None | $218.78 | $275.42 | $501.19 |
ConnectiCare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | None | $257.04 | $257.04 | $323.59 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $645.65 | Professional | None | $204.17 | $281.84 | $645.65 |
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 $85.11 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $85.11 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $33.88 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $25.70 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.98 | $26.30 | $26.30 |
Where Connecticut sits
The same service costs 3.8 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
$324
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.