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 $22.39 Median $24.55 Typical High $24.55 | Professional | None | $22.39 | $24.55 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $63.10 | Facility | None | $39.81 | $51.29 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | None | $27.54 | $27.54 | $32.36 |
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 $36.31 Median $36.31 Typical High $38.02 | Facility | None | $36.31 | $36.31 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
ConnectiCare Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
ConnectiCare Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $57.54 | Professional | None | $33.11 | $35.48 | $57.54 |
Health New England Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $48.98 | Professional | None | $19.50 | $25.12 | $48.98 |
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 $11.22 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $11.22 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.47 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.24 | $2.45 | $2.45 |
Where Connecticut sits
The same service costs 2.1 times more in Montana than in Alabama. 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· 40th 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.