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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
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 $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 $154.88 Median $173.78 Typical High $204.17 | Professional | None | $154.88 | $173.78 | $204.17 |
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 $48.98 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $10.23 | $10.23 |
Where Connecticut sits
The same service costs 2.0 times more in Alaska 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· 29th 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.