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 $416.87 Median $478.63 Typical High $478.63 | Professional | None | $416.87 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,202.26 | Facility | None | $776.25 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | None | $489.78 | $489.78 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | RR · Rental | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
ConnectiCare Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
ConnectiCare Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,071.52 | Professional | None | $630.96 | $691.83 | $1,071.52 |
Health New England Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $954.99 | Professional | None | $346.74 | $489.78 | $954.99 |
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 $208.93 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $47.86 | $47.86 |
Where Connecticut sits
The same service costs 3.9 times more in Hawaii 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· 36th of 51
$490
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.