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 Professional Modifier None Typical Low $36.31 Median $81.28 Typical High $81.28 | Professional | None | $36.31 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $18.20 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $5.37 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.25 | $8.13 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $33.88 | Professional | None | $22.39 | $30.20 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
1 more rate 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 53 · Discontinued Typical Low $0.89 Median $8.71 Typical High $19.95 | Professional | 53 · Discontinued | $0.89 | $8.71 | $19.95 |
Where Connecticut sits
The same service costs 35.5 times more in Texas than in Kentucky. 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
$30.20
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.