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 $512.86 Median $588.84 Typical High $602.56 | Professional | None | $512.86 | $588.84 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $954.99 | Facility | None | $616.60 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | RR · Rental | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | UE · Used equipment | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
ConnectiCare Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
ConnectiCare Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,000.00 | Professional | None | $457.09 | $549.54 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $870.96 | Professional | None | $436.52 | $602.56 | $870.96 |
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 $257.04 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $58.88 |
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
$708
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.