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 $47.86 Median $63.10 Typical High $63.10 | Professional | None | $47.86 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $162.18 | Facility | None | $104.71 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
ConnectiCare Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
ConnectiCare Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $131.83 | Professional | None | $70.79 | $91.20 | $131.83 |
Health New England Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $125.89 | Professional | None | $44.67 | $63.10 | $125.89 |
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 $23.99 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $9.77 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $7.24 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $6.31 |
Where Connecticut sits
The same service costs 2.4 times more in Montana 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· 35th 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.