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 $302.00 Median $331.13 Typical High $457.09 | Facility | None | $302.00 | $331.13 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $218.78 | Professional | None | $204.17 | $213.80 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $549.54 | Facility | None | $218.78 | $295.12 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $288.40 Typical High $389.05 | Facility | None | $257.04 | $288.40 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
ConnectiCare Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | None | $194.98 | $213.80 | $245.47 |
United Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | None | $181.97 | $199.53 | $223.87 |
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 $102.33 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $21.38 |
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· 49th of 51
$204
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.