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 $28.18 Median $31.62 Typical High $31.62 | Professional | None | $28.18 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $66.07 Typical High $79.43 | Facility | None | $51.29 | $66.07 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | None | $34.67 | $34.67 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | RR · Rental | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | UE · Used equipment | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Facility | None | $37.15 | $37.15 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
ConnectiCare Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
ConnectiCare Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $72.44 | Professional | None | $41.69 | $44.67 | $72.44 |
Health New England Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $61.66 | Professional | None | $24.55 | $32.36 | $61.66 |
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 $14.13 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.13 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.62 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.82 | $3.16 | $3.16 |
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· 38th of 51
$34.67
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.