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 $72.44 Median $72.44 Typical High $75.86 | Professional | None | $72.44 | $72.44 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $181.97 | Facility | None | $117.49 | $151.36 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | None | $83.18 | $83.18 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | RR · Rental | $8.32 | $8.32 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
ConnectiCare Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
ConnectiCare Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $194.98 | Professional | None | $97.72 | $112.20 | $194.98 |
Health New England Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $144.54 | Professional | None | $57.54 | $74.13 | $144.54 |
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 $36.31 Median $36.31 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.59 |
Where Connecticut sits
The same service costs 2.5 times more in Arkansas 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· 38th of 51
$83.18
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.