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 $43.65 Median $48.98 Typical High $48.98 | Professional | None | $43.65 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $123.03 | Facility | None | $79.43 | $102.33 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | RR · Rental | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
ConnectiCare Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
ConnectiCare Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $112.20 | Professional | None | $64.57 | $70.79 | $112.20 |
Health New England Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $95.50 | Professional | None | $38.02 | $50.12 | $95.50 |
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 $21.88 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $21.88 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $8.71 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $4.90 |
Where Connecticut sits
The same service costs 2.6 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· 37th of 51
$53.70
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.