How much rates vary
Facilitymedian $4,365 · 10th to 90th $851 to $12,589Professionalmedian $1,288 · 10th to 90th $589 to $1,905
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 $3,388.44 Median $5,011.87 Typical High $11,481.54 | Facility | None | $3,388.44 | $5,011.87 | $11,481.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None (both parts) | $794.33 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $309.03 Typical High $380.19 | Professional | 26 · Professional part | $251.19 | $309.03 | $380.19 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | TC · Technical part | $549.54 | $691.83 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $3,162.28 Typical High $13,803.84 | Facility | None | $588.84 | $3,162.28 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $660.69 Median $1,288.25 Typical High $1,778.28 | Professional | None (both parts) | $660.69 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $426.58 Typical High $562.34 | Professional | 26 · Professional part | $208.93 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $457.09 Median $870.96 Typical High $1,258.93 | Professional | TC · Technical part | $457.09 | $870.96 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $2,089.30 Typical High $10,715.19 | Facility | None | $416.87 | $2,089.30 | $10,715.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $407.38 Median $1,122.02 Typical High $1,905.46 | Professional | None (both parts) | $407.38 | $1,122.02 | $1,905.46 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $281.84 Median $371.54 Typical High $602.56 | Professional | 26 · Professional part | $281.84 | $371.54 | $602.56 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $107.15 Median $776.25 Typical High $1,288.25 | Professional | TC · Technical part | $107.15 | $776.25 | $1,288.25 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $1,318.26 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $11,748.98 | Facility | None | $870.96 | $5,495.41 | $11,748.98 |
United Setting Professional Modifier None (both parts) Typical Low $562.34 Median $1,096.48 Typical High $2,630.27 | Professional | None (both parts) | $562.34 | $1,096.48 | $2,630.27 |
United Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $363.08 Typical High $812.83 | Professional | 26 · Professional part | $239.88 | $363.08 | $812.83 |
United Setting Professional Modifier TC · Technical part Typical Low $489.78 Median $758.58 Typical High $1,819.70 | Professional | TC · Technical part | $489.78 | $758.58 | $1,819.70 |
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 $346.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Where Connecticut sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 14th of 51
$1,318
WI $2,630TX $603
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.