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 $38.02 Median $42.66 Typical High $46.77 | Professional | None | $38.02 | $42.66 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $107.15 | Facility | None | $69.18 | $89.13 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | None | $52.48 | $53.70 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $70.79 | Facility | None | $66.07 | $66.07 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
ConnectiCare Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
ConnectiCare Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $97.72 | Professional | None | $57.54 | $61.66 | $97.72 |
Health New England Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $85.11 | Professional | None | $33.11 | $43.65 | $85.11 |
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 $21.38 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.68 |
Where Connecticut sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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· 40th of 51
$52.48
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.