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 $15.14 Median $16.60 Typical High $16.60 | Professional | None | $15.14 | $16.60 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $35.48 Typical High $42.66 | Facility | None | $26.92 | $35.48 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | UE · Used equipment | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Facility | None | $24.55 | $24.55 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
ConnectiCare Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
ConnectiCare Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $38.90 | Professional | None | $22.39 | $23.99 | $38.90 |
Health New England Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $33.11 | Professional | None | $13.18 | $16.98 | $33.11 |
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 $7.59 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $7.59 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.02 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.24 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.51 | $1.66 | $1.66 |
Where Connecticut sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 42nd of 51
$18.62
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.