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 $257.04 Median $275.42 Typical High $275.42 | Professional | None | $257.04 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $691.83 | Facility | None | $446.68 | $575.44 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | RR · Rental | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | UE · Used equipment | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Facility | None | $363.08 | $363.08 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
ConnectiCare Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
ConnectiCare Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $660.69 | Professional | None | $363.08 | $398.11 | $660.69 |
Health New England Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Health New England Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $537.03 | Professional | None | $213.80 | $281.84 | $537.03 |
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 $128.82 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $27.54 |
Where Connecticut sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$309
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.