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 $81.28 Median $85.11 Typical High $87.10 | Professional | None | $81.28 | $85.11 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $213.80 | Facility | None | $138.04 | $177.83 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | None | $100.00 | $100.00 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | RR · Rental | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | UE · Used equipment | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
ConnectiCare Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
ConnectiCare Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $208.93 | Professional | None | $112.20 | $123.03 | $208.93 |
Health New England Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $169.82 | Professional | None | $66.07 | $87.10 | $169.82 |
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 $40.74 Median $42.66 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $8.71 |
Where Connecticut sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 38th of 51
$100
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.