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 $31.62 Median $45.71 Typical High $52.48 | Professional | None | $31.62 | $45.71 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $114.82 | Facility | None | $74.13 | $95.50 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $48.98 | Professional | None | $42.66 | $43.65 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
ConnectiCare Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
ConnectiCare Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $89.13 | Professional | None | $47.86 | $64.57 | $89.13 |
Health New England Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $89.13 | Professional | None | $32.36 | $45.71 | $89.13 |
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 $16.60 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $16.60 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $6.76 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.01 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.39 | $4.57 | $4.57 |
Where Connecticut sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 35th of 51
$43.65
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.