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 $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $269.15 | Facility | None | $173.78 | $223.87 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
ConnectiCare Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
ConnectiCare Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $239.88 | Professional | None | $125.89 | $151.36 | $239.88 |
Health New England Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $239.88 | Professional | None | $120.23 | $169.82 | $239.88 |
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 $72.44 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $16.22 | $16.22 |
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
$195
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.