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 $52.48 Median $56.23 Typical High $70.79 | Professional | None | $52.48 | $56.23 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $144.54 | Facility | None | $91.20 | $117.49 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $74.13 | Professional | None | $67.61 | $69.18 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | RR · Rental | $6.76 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Facility | None | $89.13 | $89.13 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
ConnectiCare Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
ConnectiCare Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $134.90 | Professional | None | $75.86 | $81.28 | $134.90 |
Health New England Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $112.20 | Professional | None | $44.67 | $57.54 | $112.20 |
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 $26.30 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $26.30 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.94 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $5.62 |
Where Connecticut sits
The same service costs 2.8 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· 41st of 51
$67.61
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.