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 $44.67 Median $44.67 Typical High $45.71 | Professional | None | $44.67 | $44.67 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $93.33 Typical High $112.20 | Facility | None | $72.44 | $93.33 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | None | $54.95 | $57.54 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Facility | None | $63.10 | $63.10 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
ConnectiCare Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
ConnectiCare Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $117.49 | Professional | None | $60.26 | $69.18 | $117.49 |
Health New England Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Health New England Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $89.13 | Professional | None | $35.48 | $45.71 | $89.13 |
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 $22.39 Median $22.39 Typical High $22.91 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.57 |
Where Connecticut sits
The same service costs 4.3 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· 38th of 51
$54.95
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.