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 $151.36 Median $223.87 Typical High $229.09 | Professional | None | $151.36 | $223.87 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $562.34 | Facility | None | $363.08 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | None | $208.93 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | RR · Rental | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | UE · Used equipment | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Facility | None | $213.80 | $213.80 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
ConnectiCare Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
ConnectiCare Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $426.58 | Professional | None | $229.09 | $316.23 | $426.58 |
Health New England Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $446.68 | Professional | None | $154.88 | $223.87 | $446.68 |
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 $79.43 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $31.62 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $22.39 |
Where Connecticut sits
The same service costs 4.4 times more in Hawaii 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· 34th of 51
$214
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.