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 $79.43 Median $87.10 Typical High $120.23 | Facility | None | $79.43 | $87.10 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $60.26 | Professional | None | $56.23 | $58.88 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $81.28 Typical High $151.36 | Facility | None | $57.54 | $81.28 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $79.43 Typical High $107.15 | Facility | None | $69.18 | $79.43 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
ConnectiCare Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | None | $58.88 | $58.88 | $67.61 |
United Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $58.88 | Professional | None | $47.86 | $53.70 | $58.88 |
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 $28.18 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $5.89 |
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· 38th of 51
$56.23
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.