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 $83.18 Median $93.33 Typical High $93.33 | Professional | None | $83.18 | $93.33 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $234.42 | Facility | None | $151.36 | $194.98 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $117.49 | Professional | None | $112.20 | $114.82 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
ConnectiCare Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $213.80 | Professional | None | $123.03 | $131.83 | $213.80 |
Health New England Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $181.97 | Professional | None | $64.57 | $95.50 | $181.97 |
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 $41.69 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $41.69 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.60 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.32 | $9.33 | $9.33 |
Where Connecticut sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 29th of 51
$115
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.