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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | None | $457.09 | $478.63 | $478.63 |
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 $204.17 Median $1,412.54 Typical High $1,412.54 | Professional | None | $204.17 | $1,412.54 | $1,412.54 |
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 $229.09 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $47.86 |
Where Connecticut sits
The same service costs 12.0 times more in Wyoming 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· 43rd 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.