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 $32.36 Median $37.15 Typical High $37.15 | Professional | None | $32.36 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $79.43 Typical High $95.50 | Facility | None | $60.26 | $79.43 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $44.67 | Professional | None | $40.74 | $41.69 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Facility | None | $36.31 | $36.31 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
ConnectiCare Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
ConnectiCare Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $83.18 | Professional | None | $48.98 | $53.70 | $83.18 |
Health New England Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Health New England Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $74.13 | Professional | None | $28.84 | $38.02 | $74.13 |
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 $16.22 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $6.46 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.24 | $3.72 | $3.72 |
Where Connecticut sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 33rd of 51
$40.74
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.