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 $162.18 Median $177.83 Typical High $213.80 | Professional | None | $162.18 | $177.83 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $457.09 | Facility | None | $295.12 | $380.19 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | None | $213.80 | $223.87 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $223.87 | Facility | None | $208.93 | $208.93 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
ConnectiCare Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
ConnectiCare Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $416.87 | Professional | None | $239.88 | $257.04 | $416.87 |
Health New England Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Health New England Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $354.81 | Professional | None | $125.89 | $186.21 | $354.81 |
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 $81.28 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $32.36 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $17.78 |
Where Connecticut sits
The same service costs 2.4 times more in Hawaii 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· 32nd 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.