How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $5.75 | Professional | None | $3.89 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.72 | Professional | None | $3.47 | $3.47 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.37 | Professional | RR · Rental | $0.34 | $0.34 | $0.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
ConnectiCare Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
ConnectiCare Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $10.00 | Professional | None | $5.89 | $6.31 | $10.00 |
Health New England Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Health New England Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.47 Typical High $7.76 | Professional | None | $3.31 | $4.47 | $7.76 |
2 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 55 · Aftercare only Typical Low $0.65 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.65 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.43 | $0.58 | $0.58 |
Where Connecticut sits
The same service costs 4.2 times more in Hawaii 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· 48th of 51
$4.37
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.