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 $12.88 Median $14.45 Typical High $19.50 | Professional | None | $12.88 | $14.45 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $30.20 Typical High $36.31 | Facility | None | $23.44 | $30.20 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $19.95 | Professional | None | $18.20 | $18.62 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $30.20 | Facility | None | $22.39 | $22.39 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
ConnectiCare Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
ConnectiCare Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $32.36 | Professional | None | $19.50 | $21.38 | $32.36 |
Health New England Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Professional | None | $15.14 | $15.14 | $16.22 |
United Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $28.84 | Professional | None | $11.48 | $14.79 | $28.84 |
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 $6.46 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $6.46 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.63 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $1.95 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.32 | $1.45 | $1.45 |
Where Connecticut sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 33rd of 51
$18.20
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.