How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $26.30 | Professional | None | $16.98 | $19.05 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $60.26 | Professional | None | $22.91 | $35.48 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
ConnectiCare Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $52.48 | Professional | None | $30.90 | $38.90 | $52.48 |
United Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $67.61 | Professional | None | $16.60 | $31.62 | $67.61 |
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 $8.51 Median $9.55 Typical High $13.18 | Professional | 52 · Reduced service | $8.51 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.80 Typical High $5.25 | Professional | 53 · Discontinued | $3.39 | $3.80 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.88 Typical High $3.89 | Professional | 55 · Aftercare only | $2.51 | $2.88 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.91 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.70 | $1.91 | $2.63 |
Where Connecticut sits
The same service costs 4.1 times more in Wyoming 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· 17th of 51
$31.62
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.