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 $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $218.78 | Facility | None | $138.04 | $177.83 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | None | $107.15 | $107.15 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $114.82 | Facility | None | $109.65 | $109.65 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
ConnectiCare Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
ConnectiCare Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $245.47 | Professional | None | $114.82 | $131.83 | $245.47 |
Health New England Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $169.82 | Professional | None | $67.61 | $87.10 | $169.82 |
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 $42.66 Median $42.66 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.55 |
Where Connecticut sits
The same service costs 3.0 times more in Montana 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· 37th of 51
$107
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.