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 $331.13 Median $371.54 Typical High $501.19 | Facility | None | $331.13 | $371.54 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | None | $229.09 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $602.56 | Facility | None | $239.88 | $323.59 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $323.59 Typical High $436.52 | Facility | None | $281.84 | $323.59 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $275.42 | Professional | None | $218.78 | $234.42 | $275.42 |
United Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | None | $199.53 | $223.87 | $245.47 |
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 $114.82 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $23.44 |
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· 50th of 51
$229
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.