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 $38.02 Median $57.54 Typical High $58.88 | Professional | None | $38.02 | $57.54 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $144.54 | Facility | None | $93.33 | $120.23 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $58.88 | Professional | None | $53.70 | $54.95 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $69.18 | Facility | None | $66.07 | $66.07 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
ConnectiCare Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
ConnectiCare Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $109.65 | Professional | None | $58.88 | $81.28 | $109.65 |
Health New England Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $112.20 | Professional | None | $39.81 | $56.23 | $112.20 |
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 $21.88 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.71 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $6.61 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $5.75 |
Where Connecticut sits
The same service costs 3.6 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· 37th of 51
$54.95
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.