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 $181.97 Median $257.04 Typical High $257.04 | Professional | None | $181.97 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $645.65 | Facility | None | $416.87 | $537.03 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | RR · Rental | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
ConnectiCare Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $524.81 | Professional | None | $281.84 | $363.08 | $524.81 |
Health New England Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $501.19 | Professional | None | $177.83 | $251.19 | $501.19 |
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 $91.20 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $36.31 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $27.54 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.20 | $25.70 | $25.70 |
Where Connecticut sits
The same service costs 2.9 times more in Montana 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· 31st of 51
$245
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.