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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | None | $91.20 | $91.20 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | None | $100.00 | $117.49 | $151.36 |
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 $131.83 Median $204.17 Typical High $257.04 | Professional | None | $131.83 | $204.17 | $257.04 |
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 $45.71 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $26.30 | Professional | 53 · Discontinued | $18.20 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.88 |
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· 28th 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.