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 $72.44 Median $83.18 Typical High $100.00 | Professional | None | $72.44 | $83.18 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $173.78 Typical High $208.93 | Facility | None | $134.90 | $173.78 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $97.72 | Professional | None | $89.13 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | UE · Used equipment | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $102.33 | Facility | None | $97.72 | $97.72 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
ConnectiCare Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
ConnectiCare Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $177.83 | Professional | None | $109.65 | $123.03 | $177.83 |
Health New England Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Health New England Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | None | $204.17 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $165.96 | Professional | None | $61.66 | $85.11 | $165.96 |
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 $36.31 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $14.45 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.24 | $8.32 | $8.32 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$89.13
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.