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 Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $954.99 | Facility | None | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | None | $416.87 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $1,230.27 | Facility | None | $436.52 | $630.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $616.60 Typical High $851.14 | Facility | None | $549.54 | $616.60 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
ConnectiCare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
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 $208.93 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $43.65 |
Where Connecticut sits
The same service costs 6.5 times more in Minnesota than in Montana. 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· 4th of 51
$437
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.