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 $26.30 Median $28.84 Typical High $34.67 | Professional | None | $26.30 | $28.84 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $74.13 | Facility | None | $46.77 | $61.66 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $36.31 | Professional | None | $33.11 | $34.67 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | RR · Rental | $3.31 | $3.31 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
ConnectiCare Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
ConnectiCare Setting Professional Modifier None Typical Low $38.90 Median $41.69 Typical High $67.61 | Professional | None | $38.90 | $41.69 | $67.61 |
Health New England Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Health New England Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $57.54 | Professional | None | $22.91 | $30.20 | $57.54 |
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 $13.18 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.25 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $3.89 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.63 | $2.88 | $2.88 |
Where Connecticut sits
The same service costs 2.8 times more in Montana than in Kansas. 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
$33.11
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.