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 $52.48 Median $69.18 Typical High $69.18 | Professional | None | $52.48 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | None | $69.18 | $69.18 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
ConnectiCare Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
ConnectiCare Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $120.23 | Professional | None | $70.79 | $75.86 | $120.23 |
Health New England Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $95.50 | Professional | None | $39.81 | $53.70 | $95.50 |
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 $26.30 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $26.30 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $10.47 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $7.94 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.25 | $6.92 | $6.92 |
Where Connecticut sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 26th of 51
$69.18
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.