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 $20.89 Median $23.44 Typical High $23.99 | Professional | None | $20.89 | $23.44 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $58.88 | Facility | None | $38.02 | $48.98 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | None | $25.70 | $25.70 | $28.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | RR · Rental | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | UE · Used equipment | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Facility | None | $33.88 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
ConnectiCare Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
ConnectiCare Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $53.70 | Professional | None | $30.90 | $33.88 | $53.70 |
Health New England Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $45.71 | Professional | None | $18.20 | $23.99 | $45.71 |
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 $10.47 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $10.47 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.17 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.16 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.09 | $2.34 | $2.34 |
Where Connecticut sits
The same service costs 3.1 times more in Montana 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· 40th of 51
$25.70
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.