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 $46.77 Median $67.61 Typical High $67.61 | Professional | None | $46.77 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $169.82 | Facility | None | $109.65 | $141.25 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
ConnectiCare Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
ConnectiCare Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $138.04 | Professional | None | $69.18 | $93.33 | $138.04 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $131.83 | Professional | None | $46.77 | $66.07 | $131.83 |
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 $23.44 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $23.44 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $9.33 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $6.76 |
Where Connecticut sits
The same service costs 2.8 times more in Wisconsin 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· 37th of 51
$60.26
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.