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 $144.54 Median $144.54 Typical High $234.42 | Facility | None | $144.54 | $144.54 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $165.96 | Professional | None | $107.15 | $134.90 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $199.53 | Professional | None | $91.20 | $107.15 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $213.80 | Professional | None | $117.49 | $169.82 | $213.80 |
ConnectiCare Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $173.78 | Professional | None | $102.33 | $131.83 | $173.78 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | None | $181.97 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $234.42 | Professional | None | $114.82 | $154.88 | $234.42 |
3 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 $50.12 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $50.12 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $15.14 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.00 | $15.85 | $15.85 |
Where Connecticut sits
The same service costs 2.0 times more in Alaska 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· 24th 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.