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 $89.13 Median $100.00 Typical High $114.82 | Professional | None | $89.13 | $100.00 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $251.19 | Facility | None | $162.18 | $208.93 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | None | $114.82 | $117.49 | $125.89 |
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 $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
ConnectiCare Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
ConnectiCare Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $229.09 | Professional | None | $131.83 | $144.54 | $229.09 |
Health New England Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $79.43 | Facility | None | $60.26 | $60.26 | $79.43 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $199.53 | Professional | None | $70.79 | $102.33 | $199.53 |
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 $44.67 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $10.00 |
Where Connecticut sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 35th 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.