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 $60.26 Median $67.61 Typical High $77.62 | Professional | None | $60.26 | $67.61 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $169.82 | Facility | None | $109.65 | $141.25 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $81.28 | Professional | None | $74.13 | $75.86 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | RR · Rental | $7.41 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | UE · Used equipment | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
ConnectiCare Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
ConnectiCare Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $151.36 | Professional | None | $91.20 | $100.00 | $151.36 |
Health New England Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $134.90 | Professional | None | $51.29 | $69.18 | $134.90 |
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 $30.20 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.02 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $6.76 |
Where Connecticut sits
The same service costs 3.1 times more in Hawaii 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· 33rd of 51
$74.13
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.