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 $95.50 Median $117.49 Typical High $128.82 | Facility | None | $95.50 | $117.49 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | None | $63.10 | $66.07 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $162.18 | Facility | None | $69.18 | $97.72 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $120.23 | Facility | None | $70.79 | $70.79 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
ConnectiCare Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | None | $64.57 | $64.57 | $75.86 |
United Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | None | $51.29 | $57.54 | $60.26 |
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 $31.62 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $6.61 |
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· 28th of 51
$63.10
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.