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 $48.98 Median $54.95 Typical High $54.95 | Professional | None | $48.98 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $138.04 | Facility | None | $89.13 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | UE · Used equipment | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | None | $70.79 | $70.79 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
ConnectiCare Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
ConnectiCare Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $125.89 | Professional | None | $74.13 | $79.43 | $125.89 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $109.65 | Professional | None | $42.66 | $56.23 | $109.65 |
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 $24.55 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $24.55 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.41 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.90 | $5.50 | $5.50 |
Where Connecticut sits
The same service costs 2.4 times more in Montana than in Delaware. 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
$66.07
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.