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 $60.26 Median $85.11 Typical High $85.11 | Professional | None | $60.26 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $181.97 Typical High $218.78 | Facility | None | $141.25 | $181.97 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $89.13 | Professional | None | $79.43 | $81.28 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | RR · Rental | $7.94 | $7.94 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | UE · Used equipment | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Facility | None | $107.15 | $107.15 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
ConnectiCare Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
ConnectiCare Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $165.96 | Professional | None | $87.10 | $120.23 | $165.96 |
Health New England Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $169.82 | Professional | None | $60.26 | $85.11 | $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 $29.51 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $29.51 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $12.02 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $8.51 |
Where Connecticut sits
The same service costs 5.1 times more in Hawaii than in Florida. 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
$81.28
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.