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 $38.02 Median $41.69 Typical High $43.65 | Professional | None | $38.02 | $41.69 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $107.15 | Facility | None | $69.18 | $89.13 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $53.70 | Professional | None | $46.77 | $47.86 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | RR · Rental | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Facility | None | $50.12 | $50.12 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
ConnectiCare Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
ConnectiCare Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $97.72 | Professional | None | $56.23 | $60.26 | $97.72 |
Health New England Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $93.33 | Professional | None | $20.89 | $20.89 | $93.33 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $83.18 | Professional | None | $33.11 | $43.65 | $83.18 |
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 $19.05 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.59 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.80 | $4.27 | $4.27 |
Where Connecticut sits
The same service costs 3.0 times more in Hawaii 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· 38th of 51
$46.77
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.