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 $38.90 Median $43.65 Typical High $43.65 | Professional | None | $38.90 | $43.65 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $109.65 | Facility | None | $70.79 | $91.20 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | None | $47.86 | $47.86 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | UE · Used equipment | $36.31 | $36.31 | $36.31 |
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
ConnectiCare Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $95.50 | Professional | None | $58.88 | $63.10 | $95.50 |
Health New England Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $33.88 Median $44.67 Typical High $87.10 | Professional | None | $33.88 | $44.67 | $87.10 |
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 $19.50 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $19.50 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $7.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.89 | $4.37 | $4.37 |
Where Connecticut sits
The same service costs 2.3 times more in Montana than in Florida. 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
$47.86
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.