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 $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $89.13 | Facility | None | $57.54 | $74.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | None | $40.74 | $40.74 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $43.65 | Facility | None | $41.69 | $41.69 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
ConnectiCare Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
ConnectiCare Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $81.28 | Professional | None | $47.86 | $51.29 | $81.28 |
Health New England Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $70.79 | Professional | None | $28.18 | $36.31 | $70.79 |
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 $15.85 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $15.85 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.46 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.79 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.24 | $3.55 | $3.55 |
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· 31st of 51
$40.74
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.