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 $199.53 Median $269.15 Typical High $295.12 | Professional | None | $199.53 | $269.15 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $676.08 | Facility | None | $436.52 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $281.84 | Professional | None | $251.19 | $263.03 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | RR · Rental | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | UE · Used equipment | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
ConnectiCare Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $562.34 | Professional | None | $302.00 | $389.05 | $562.34 |
Health New England Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $537.03 | Professional | None | $190.55 | $269.15 | $537.03 |
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 $100.00 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $100.00 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $39.81 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $29.51 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.95 | $26.92 | $26.92 |
Where Connecticut sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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
$263
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.