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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $17.38 Typical High $17.38 | Professional | None | $11.22 | $17.38 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $29,512.09 Median $33,884.42 Typical High $42,657.95 | Facility | None | $29,512.09 | $33,884.42 | $42,657.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $22.91 Typical High $34.67 | Professional | None | $12.30 | $22.91 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
ConnectiCare Setting Professional Modifier None Typical Low $11.75 Median $16.60 Typical High $23.44 | Professional | None | $11.75 | $16.60 | $23.44 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $26.92 | Professional | None | $12.02 | $18.20 | $26.92 |
5 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 $5.89 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $5.89 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $2.34 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $12.88 Typical High $12.88 | Professional | 54 · Surgery only | $8.91 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $1.78 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.17 | $1.74 | $1.74 |
Where Connecticut sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 11th of 51
$19.95
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.