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 $239.88 Median $269.15 Typical High $323.59 | Professional | None | $239.88 | $269.15 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $676.08 | Facility | None | $436.52 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $331.13 | Professional | None | $229.09 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | RR · Rental | $22.91 | $22.91 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | UE · Used equipment | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Facility | None | $316.23 | $316.23 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
ConnectiCare Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
ConnectiCare Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $616.60 | Professional | None | $354.81 | $389.05 | $616.60 |
Health New England Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | None | $295.12 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $524.81 | Professional | None | $208.93 | $275.42 | $524.81 |
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 $120.23 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $47.86 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $26.92 |
Where Connecticut sits
The same service costs 2.6 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· 49th of 51
$251
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.