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 $169.82 Median $199.53 Typical High $199.53 | Professional | None | $169.82 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $323.59 | Facility | None | $208.93 | $269.15 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | None | $234.42 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | RR · Rental | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | UE · Used equipment | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
ConnectiCare Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
ConnectiCare Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $338.84 | Professional | None | $154.88 | $181.97 | $338.84 |
Health New England Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
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 $87.10 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $19.95 |
Where Connecticut sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 22nd of 51
$234
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.