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 $77.62 Median $95.50 Typical High $114.82 | Professional | None | $77.62 | $95.50 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $223.87 | Professional | None | $70.79 | $93.33 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $158.49 | Facility | None | $93.33 | $93.33 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $125.89 | Professional | None | $43.65 | $70.79 | $125.89 |
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 $33.88 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $33.88 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $13.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.76 | $9.55 | $9.55 |
Where Connecticut sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 13th of 51
$91.20
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.