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 $39.81 Typical High $41.69 | Professional | None | $32.36 | $39.81 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $100.00 | Facility | None | $64.57 | $83.18 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $43.65 | Professional | None | $39.81 | $40.74 | $43.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | RR · Rental | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | UE · Used equipment | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
ConnectiCare Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
ConnectiCare Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $81.28 | Professional | None | $52.48 | $58.88 | $81.28 |
Health New England Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | None | $41.69 | $41.69 | $43.65 |
United Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $77.62 | Professional | None | $28.18 | $40.74 | $77.62 |
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 $16.22 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $16.22 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.61 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $4.90 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $3.98 |
Where Connecticut sits
The same service costs 3.1 times more in Hawaii than in Florida. 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
$39.81
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.