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 $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $117.49 | Facility | None | $75.86 | $97.72 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | None | $52.48 | $53.70 | $57.54 |
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 $63.10 Median $63.10 Typical High $66.07 | Facility | None | $63.10 | $63.10 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
ConnectiCare Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
ConnectiCare Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $100.00 | Professional | None | $58.88 | $66.07 | $100.00 |
Health New England Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Health New England Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $91.20 | Professional | None | $36.31 | $47.86 | $91.20 |
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 $20.89 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $20.89 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.17 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.17 | $4.57 | $4.57 |
Where Connecticut sits
The same service costs 3.2 times more in Hawaii than in New Jersey. 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
$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.