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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $58.88 | Professional | None | $45.71 | $56.23 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $194.98 | Professional | None | $64.57 | $83.18 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $64.57 | Professional | None | $60.26 | $61.66 | $64.57 |
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 $22.39 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $22.39 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $12.02 | Professional | 53 · Discontinued | $9.12 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.32 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $8.32 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.47 | $5.62 | $5.89 |
Where Connecticut sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 10th of 51
$69.18
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.