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 $16.22 Median $18.20 Typical High $18.20 | Professional | None | $16.22 | $18.20 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $38.02 Typical High $45.71 | Facility | None | $29.51 | $38.02 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | None | $20.89 | $20.89 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | UE · Used equipment | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $26.92 | Facility | None | $25.70 | $25.70 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
ConnectiCare Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
ConnectiCare Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $39.81 | Professional | None | $24.55 | $26.30 | $39.81 |
Health New England Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
United Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $36.31 | Professional | None | $14.13 | $18.62 | $36.31 |
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 $8.13 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.13 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.24 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.45 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.62 | $1.82 | $1.82 |
Where Connecticut sits
The same service costs 2.2 times more in Montana than in New Jersey. 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
$20.89
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.