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 $117.49 Median $165.96 Typical High $165.96 | Professional | None | $117.49 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $416.87 | Facility | None | $269.15 | $346.74 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | None | $154.88 | $154.88 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | RR · Rental | $15.49 | $15.49 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
ConnectiCare Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $338.84 | Professional | None | $169.82 | $234.42 | $338.84 |
Health New England Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $323.59 | Professional | None | $114.82 | $165.96 | $323.59 |
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 $58.88 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $58.88 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $23.99 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $16.60 |
Where Connecticut sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 34th of 51
$155
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.