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 $45.71 Median $51.29 Typical High $52.48 | Professional | None | $45.71 | $51.29 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $107.15 Typical High $128.82 | Facility | None | $83.18 | $107.15 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | RR · Rental | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $107.15 | Facility | None | $66.07 | $66.07 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
ConnectiCare Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
ConnectiCare Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $117.49 | Professional | None | $67.61 | $72.44 | $117.49 |
Health New England Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $100.00 | Professional | None | $39.81 | $52.48 | $100.00 |
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 $23.99 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $23.99 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $10.47 | Professional | 53 · Discontinued | $9.55 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $7.08 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $5.25 |
Where Connecticut sits
The same service costs 3.5 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· 42nd of 51
$61.66
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.