How much rates vary
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 Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $316.23 | Professional | None | $218.78 | $275.42 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $302.00 | Professional | None | $190.55 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $524.81 Typical High $741.31 | Facility | None | $194.98 | $524.81 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $549.54 | Professional | None | $234.42 | $275.42 | $549.54 |
ConnectiCare Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | None | $275.42 | $281.84 | $281.84 |
Health New England Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $478.63 | Professional | None | $245.47 | $245.47 | $478.63 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $588.84 | Professional | None | $218.78 | $295.12 | $588.84 |
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 $102.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $27.54 |
Where Connecticut sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 19th of 51
$263
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.