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 $44.67 Median $50.12 Typical High $50.12 | Professional | None | $44.67 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $125.89 | Facility | None | $81.28 | $104.71 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | RR · Rental | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
ConnectiCare Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
ConnectiCare Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $114.82 | Professional | None | $66.07 | $72.44 | $114.82 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $97.72 | Professional | None | $38.90 | $51.29 | $97.72 |
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 $22.39 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $22.39 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $8.91 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.76 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.47 | $5.01 | $5.01 |
Where Connecticut sits
The same service costs 2.1 times more in Montana than in Florida. 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
$56.23
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.