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 $28.84 Median $32.36 Typical High $32.36 | Professional | None | $28.84 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $67.61 Typical High $81.28 | Facility | None | $52.48 | $67.61 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | RR · Rental | $3.72 | $3.72 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Facility | None | $40.74 | $40.74 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
ConnectiCare Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
ConnectiCare Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $69.18 | Professional | None | $41.69 | $46.77 | $69.18 |
Health New England Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $64.57 | Professional | None | $25.12 | $33.11 | $64.57 |
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 $14.45 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $14.45 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.75 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.79 Typical High $4.90 | Professional | 55 · Aftercare only | $4.37 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.88 | $3.24 | $3.24 |
Where Connecticut sits
The same service costs 2.7 times more in Montana 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· 42nd of 51
$37.15
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.