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 $31.62 Median $40.74 Typical High $40.74 | Professional | None | $31.62 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $85.11 Typical High $102.33 | Facility | None | $66.07 | $85.11 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | None | $39.81 | $39.81 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | RR · Rental | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | UE · Used equipment | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
ConnectiCare Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
ConnectiCare Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $83.18 | Professional | None | $47.86 | $58.88 | $83.18 |
Health New England Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $81.28 | Professional | None | $29.51 | $41.69 | $81.28 |
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 $15.85 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.31 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $4.79 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.16 | $4.07 | $4.07 |
Where Connecticut sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 40th of 51
$40.74
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.