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 $21.38 Median $23.99 Typical High $23.99 | Professional | None | $21.38 | $23.99 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $50.12 Typical High $60.26 | Facility | None | $38.90 | $50.12 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | None | $27.54 | $27.54 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | RR · Rental | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Facility | None | $33.88 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
ConnectiCare Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
ConnectiCare Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $54.95 | Professional | None | $32.36 | $34.67 | $54.95 |
Health New England Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $47.86 | Professional | None | $18.62 | $24.55 | $47.86 |
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 $10.72 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $10.72 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.27 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.24 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.14 | $2.40 | $2.40 |
Where Connecticut sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 35th of 51
$27.54
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.