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 $26.92 Median $34.67 Typical High $35.48 | Professional | None | $26.92 | $34.67 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $87.10 | Facility | None | $56.23 | $72.44 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $40.74 | Professional | None | $36.31 | $37.15 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | RR · Rental | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $51.29 | Facility | None | $48.98 | $48.98 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
ConnectiCare Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
ConnectiCare Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $70.79 | Professional | None | $40.74 | $48.98 | $70.79 |
Health New England Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Health New England Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $67.61 | Professional | None | $25.70 | $35.48 | $67.61 |
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 $13.49 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $13.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $5.50 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.07 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.69 | $3.47 | $3.47 |
Where Connecticut sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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
$36.31
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.