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 $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $169.82 | Facility | None | $109.65 | $141.25 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
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 $89.13 Median $89.13 Typical High $93.33 | Facility | None | $89.13 | $89.13 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
ConnectiCare Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
ConnectiCare Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $154.88 | Professional | None | $89.13 | $97.72 | $154.88 |
Health New England Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $134.90 | Professional | None | $52.48 | $69.18 | $134.90 |
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 $30.90 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.90 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.59 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.31 | $6.76 | $6.76 |
Where Connecticut sits
The same service costs 5.1 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· 36th 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.