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 Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $154.88 | Professional | None | $61.66 | $120.23 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $309.03 | Facility | None | $91.20 | $91.20 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
ConnectiCare Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $194.98 | Professional | None | $114.82 | $141.25 | $194.98 |
United Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $162.18 | Professional | None | $83.18 | $107.15 | $162.18 |
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 $45.71 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.55 |
Where Connecticut sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 18th of 51
$102
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.