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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None | $89.13 | $93.33 | $93.33 |
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 $144.54 Typical High $245.47 | Facility | None | $144.54 | $144.54 | $245.47 |
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 $93.33 Median $95.50 Typical High $190.55 | Professional | None | $93.33 | $95.50 | $190.55 |
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 $44.67 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $9.33 |
Where Connecticut sits
The same service costs 2.1 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· 35th of 51
$117
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.