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 $19.50 Median $21.88 Typical High $25.12 | Professional | None | $19.50 | $21.88 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $45.71 Typical High $54.95 | Facility | None | $35.48 | $45.71 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | RR · Rental | $2.45 | $2.45 | $2.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | UE · Used equipment | $18.20 | $18.20 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $28.18 | Facility | None | $26.92 | $26.92 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
ConnectiCare Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
ConnectiCare Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $50.12 | Professional | None | $28.84 | $31.62 | $50.12 |
Health New England Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.39 Typical High $43.65 | Professional | None | $16.98 | $22.39 | $43.65 |
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 $9.77 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $9.77 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.89 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.95 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.19 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 35th of 51
$23.99
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.