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 $131.83 Median $165.96 Typical High $165.96 | Professional | None | $131.83 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $416.87 | Facility | None | $269.15 | $346.74 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | None | $173.78 | $173.78 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | RR · Rental | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Facility | None | $223.87 | $223.87 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
ConnectiCare Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $338.84 | Professional | None | $190.55 | $239.88 | $338.84 |
Health New England Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $323.59 | Professional | None | $123.03 | $169.82 | $323.59 |
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 $66.07 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $66.07 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $26.30 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.50 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.18 | $16.60 | $16.60 |
Where Connecticut sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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
$174
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.