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 $91.20 Median $151.36 Typical High $309.03 | Professional | None | $91.20 | $151.36 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $977.24 | Professional | None | $79.43 | $213.80 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $363.08 Typical High $467.74 | Facility | None | $251.19 | $363.08 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $1,288.25 | Professional | None | $112.20 | $239.88 | $1,288.25 |
ConnectiCare Setting Professional Modifier None Typical Low $239.88 Median $870.96 Typical High $1,445.44 | Professional | None | $239.88 | $870.96 | $1,445.44 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $6,165.95 Typical High $9,549.93 | Facility | None | $3,311.31 | $6,165.95 | $9,549.93 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $1,412.54 | Professional | None | $100.00 | $251.19 | $1,412.54 |
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 $45.71 Median $74.13 Typical High $154.88 | Professional | 52 · Reduced service | $45.71 | $74.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.20 Typical High $61.66 | Professional | 53 · Discontinued | $18.20 | $30.20 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $112.20 Typical High $234.42 | Professional | 54 · Surgery only | $69.18 | $112.20 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.39 Typical High $46.77 | Professional | 55 · Aftercare only | $13.80 | $22.39 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.14 Typical High $30.90 | Professional | 56 · Pre-op care only | $9.12 | $15.14 | $30.90 |
Where Connecticut sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 25th of 51
$234
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.