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 $12.02 Median $15.14 Typical High $16.22 | Facility | None | $12.02 | $15.14 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | None | $8.13 | $8.51 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $11.75 Typical High $20.89 | Facility | None | $8.91 | $11.75 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $15.49 | Facility | None | $9.12 | $9.12 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
ConnectiCare Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $9.77 | Professional | None | $8.13 | $8.51 | $9.77 |
Health New England Setting Facility Modifier None Typical Low $12.59 Median $48.98 Typical High $52.48 | Facility | None | $12.59 | $48.98 | $52.48 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | None | $6.46 | $7.24 | $7.59 |
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 $4.07 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $1.23 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.85 | $0.85 |
Where Connecticut sits
Rates are fairly even across states for this service. 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
$8.13
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.