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 $37.15 Median $44.67 Typical High $44.67 | Professional | None | $37.15 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $72.44 | Facility | None | $46.77 | $60.26 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $53.70 | Facility | None | $52.48 | $52.48 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
ConnectiCare Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
ConnectiCare Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $64.57 | Professional | None | $34.67 | $41.69 | $64.57 |
Health New England Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $66.07 | Professional | None | $33.11 | $45.71 | $66.07 |
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 $19.50 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.76 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.47 | $4.47 |
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· 16th of 51
$53.70
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.