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 $93.33 Median $123.03 Typical High $123.03 | Professional | None | $93.33 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $316.23 | Facility | None | $204.17 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | None | $120.23 | $120.23 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | UE · Used equipment | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Facility | None | $144.54 | $144.54 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
ConnectiCare Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
ConnectiCare Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $257.04 | Professional | None | $131.83 | $177.83 | $257.04 |
Health New England Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $245.47 | Professional | None | $89.13 | $125.89 | $245.47 |
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 $46.77 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $46.77 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $18.62 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $12.30 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in Florida. 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
$123
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.