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 $4.90 Median $11.75 Typical High $11.75 | Professional | None | $4.90 | $11.75 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.63 Typical High $4.68 | Professional | None | $3.16 | $3.63 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $7.08 | Facility | None | $4.17 | $4.17 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $1.95 Median $3.16 Typical High $8.32 | Professional | None | $1.95 | $3.16 | $8.32 |
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 $2.45 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $2.45 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $0.98 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $0.72 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.49 | $1.17 | $1.17 |
Where Connecticut sits
The same service costs 4.6 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· 31st of 51
$3.72
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.