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 $162.18 Median $173.78 Typical High $173.78 | Professional | None | $162.18 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $436.52 | Facility | None | $281.84 | $363.08 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | None | $181.97 | $181.97 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | RR · Rental | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | UE · Used equipment | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Facility | None | $218.78 | $218.78 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
ConnectiCare Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
ConnectiCare Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $416.87 | Professional | None | $234.42 | $251.19 | $416.87 |
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 $128.82 Median $177.83 Typical High $346.74 | Professional | None | $128.82 | $177.83 | $346.74 |
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 $79.43 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $17.38 |
Where Connecticut sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 38th of 51
$182
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.