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 $64.57 Median $72.44 Typical High $89.13 | Professional | None | $64.57 | $72.44 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $181.97 | Facility | None | $117.49 | $151.36 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | None | $85.11 | $87.10 | $95.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | RR · Rental | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
ConnectiCare Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
ConnectiCare Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $158.49 | Professional | None | $93.33 | $104.71 | $158.49 |
Health New England Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Health New England Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $141.25 | Professional | None | $56.23 | $74.13 | $141.25 |
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 $32.36 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $32.36 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.88 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.77 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.46 | $7.24 | $7.24 |
Where Connecticut sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 42nd of 51
$85.11
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.