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 $91.20 Median $100.00 Typical High $100.00 | Professional | None | $91.20 | $100.00 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $257.04 | Facility | None | $162.18 | $208.93 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | None | $114.82 | $114.82 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
ConnectiCare Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
ConnectiCare Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $234.42 | Professional | None | $134.90 | $144.54 | $234.42 |
Health New England Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $199.53 | Professional | None | $79.43 | $102.33 | $199.53 |
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 $45.71 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $10.00 |
Where Connecticut sits
The same service costs 5.4 times more in Kansas 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· 37th of 51
$115
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.