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 $7.76 Median $11.22 Typical High $11.22 | Professional | None | $7.76 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $15.14 Typical High $18.20 | Professional | None | $9.12 | $15.14 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $19.05 Typical High $489.78 | Facility | None | $4.79 | $19.05 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $20.42 | Professional | None | $11.22 | $16.60 | $20.42 |
ConnectiCare Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $17.78 | Professional | None | $10.00 | $12.30 | $17.78 |
United Setting Professional Modifier None Typical Low $7.94 Median $12.88 Typical High $20.42 | Professional | None | $7.94 | $12.88 | $20.42 |
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 $3.80 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $3.80 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $1.55 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.75 Median $8.32 Typical High $8.32 | Professional | 54 · Surgery only | $5.75 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.15 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.78 | $1.12 | $1.12 |
Where Connecticut sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$13.18
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.