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 $257.04 Median $407.38 Typical High $724.44 | Facility | None | $257.04 | $407.38 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $199.53 | Professional | None | $50.12 | $104.71 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $371.54 | Professional | None | $77.62 | $158.49 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $478.63 Typical High $794.33 | Facility | None | $128.82 | $478.63 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $147.91 Typical High $208.93 | Professional | None | $50.12 | $147.91 | $208.93 |
ConnectiCare Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $223.87 | Professional | None | $114.82 | $147.91 | $223.87 |
United Setting Professional Modifier None Typical Low $42.66 Median $114.82 Typical High $239.88 | Professional | None | $42.66 | $114.82 | $239.88 |
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 $23.44 Median $52.48 Typical High $100.00 | Professional | 52 · Reduced service | $23.44 | $52.48 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $20.89 Typical High $39.81 | Professional | 53 · Discontinued | $9.55 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $15.85 Typical High $30.20 | Professional | 55 · Aftercare only | $7.08 | $15.85 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $10.47 Typical High $19.95 | Professional | 56 · Pre-op care only | $4.79 | $10.47 | $19.95 |
Where Connecticut sits
The same service costs 3.5 times more in Wisconsin 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· 14th of 51
$135
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.