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 $35.48 Median $48.98 Typical High $48.98 | Professional | None | $35.48 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $125.89 | Facility | None | $79.43 | $104.71 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | None | $45.71 | $45.71 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Facility | None | $54.95 | $54.95 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
ConnectiCare Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
ConnectiCare Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $102.33 | Professional | None | $54.95 | $70.79 | $102.33 |
Health New England Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $97.72 | Professional | None | $34.67 | $48.98 | $97.72 |
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 $17.78 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $17.78 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.08 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $5.37 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.55 | $4.90 | $4.90 |
Where Connecticut sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 36th of 51
$45.71
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.