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 $20.42 Median $47.86 Typical High $47.86 | Professional | None | $20.42 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $52.48 | Professional | None | $21.38 | $33.11 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $501.19 Typical High $741.31 | Facility | None | $204.17 | $501.19 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $52.48 Typical High $66.07 | Professional | None | $31.62 | $52.48 | $66.07 |
ConnectiCare Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $57.54 | Professional | None | $32.36 | $51.29 | $57.54 |
United Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $79.43 | Professional | None | $29.51 | $42.66 | $79.43 |
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 $10.47 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $10.47 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $4.27 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $3.16 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.14 | $4.79 | $4.79 |
Where Connecticut sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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
$38.90
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.