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 $141.25 Median $194.98 Typical High $194.98 | Professional | None | $141.25 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $295.12 | Facility | None | $190.55 | $245.47 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $213.80 | Professional | None | $199.53 | $204.17 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | RR · Rental | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Facility | None | $213.80 | $213.80 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
ConnectiCare Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
ConnectiCare Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $275.42 | Professional | None | $147.91 | $165.96 | $275.42 |
Health New England Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $269.15 | Professional | None | $123.03 | $194.98 | $269.15 |
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 $70.79 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $70.79 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $28.18 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.13 | $19.50 | $19.50 |
Where Connecticut sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 27th of 51
$200
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.