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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | None | $134.90 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $154.88 | Professional | None | $100.00 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $295.12 | Facility | None | $144.54 | $234.42 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
ConnectiCare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $141.25 | Professional | None | $114.82 | $125.89 | $141.25 |
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 $67.61 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $67.61 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $26.92 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $13.80 |
Where Connecticut sits
The same service costs 2.3 times more in North Dakota 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· 41st of 51
$126
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.