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 $4,570.88 Median $6,760.83 Typical High $11,481.54 | Facility | None | $4,570.88 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $2,691.53 Typical High $2,691.53 | Professional | None | $39.81 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $26,915.35 Typical High $87,096.36 | Facility | None | $3,715.35 | $26,915.35 | $87,096.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $549.54 | Professional | None | $371.54 | $436.52 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,265.80 | Facility | None | $512.86 | $1,000.00 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $8,912.51 | Facility | None | $537.03 | $1,258.93 | $8,912.51 |
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 $19.95 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $19.95 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $7.94 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $30.20 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $6.03 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $3.98 | $269.15 | $269.15 |
Where Connecticut sits
The same service costs 295.1 times more in Alaska than in West Virginia. 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· 40th of 51
$513
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.