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 $83.18 Median $91.20 Typical High $91.20 | Professional | None | $83.18 | $91.20 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $229.09 | Facility | None | $147.91 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | RR · Rental | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | UE · Used equipment | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Facility | None | $107.15 | $107.15 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
ConnectiCare Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $213.80 | Professional | None | $123.03 | $131.83 | $213.80 |
Health New England Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $181.97 | Professional | None | $64.57 | $93.33 | $181.97 |
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 $40.74 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $40.74 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $9.12 |
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· 32nd of 51
$100
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.