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 $24.55 Median $36.31 Typical High $36.31 | Professional | None | $24.55 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $54.95 Typical High $66.07 | Facility | None | $42.66 | $54.95 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $38.90 | Professional | None | $30.90 | $30.90 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | RR · Rental | $3.09 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | UE · Used equipment | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
ConnectiCare Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
ConnectiCare Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $63.10 | Professional | None | $35.48 | $38.02 | $63.10 |
Health New England Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Health New England Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $47.86 | Professional | None | $20.42 | $26.92 | $47.86 |
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 $14.45 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $14.45 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.88 | $3.63 | $3.63 |
Where Connecticut sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 38th of 51
$30.90
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.