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 $41.69 Median $46.77 Typical High $54.95 | Professional | None | $41.69 | $46.77 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $117.49 | Facility | None | $75.86 | $97.72 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | None | $52.48 | $53.70 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $69.18 | Facility | None | $66.07 | $66.07 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
ConnectiCare Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
ConnectiCare Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $102.33 | Professional | None | $61.66 | $67.61 | $102.33 |
Health New England Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $91.20 | Professional | None | $36.31 | $47.86 | $91.20 |
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 $20.89 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.31 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.17 | $4.68 | $4.68 |
Where Connecticut sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 38th of 51
$52.48
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.