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 $64.57 Median $74.13 Typical High $87.10 | Professional | None | $64.57 | $74.13 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $186.21 | Facility | None | $120.23 | $154.88 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $91.20 | Professional | None | $81.28 | $85.11 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | RR · Rental | $8.13 | $8.13 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $138.04 | Facility | None | $87.10 | $87.10 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
ConnectiCare Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
ConnectiCare Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $151.36 | Professional | None | $91.20 | $109.65 | $151.36 |
Health New England Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $144.54 | Professional | None | $57.54 | $75.86 | $144.54 |
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 $31.62 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $31.62 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $12.59 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $7.41 |
Where Connecticut sits
The same service costs 5.0 times more in Hawaii than in Delaware. 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· 36th of 51
$81.28
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.