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 $41.69 Median $61.66 Typical High $74.13 | Professional | None | $41.69 | $61.66 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $158.49 | Facility | None | $100.00 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $60.26 | Professional | None | $56.23 | $57.54 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | RR · Rental | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $97.72 | Facility | None | $61.66 | $61.66 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
ConnectiCare Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
ConnectiCare Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $128.82 | Professional | None | $63.10 | $87.10 | $128.82 |
Health New England Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Health New England Setting Professional Modifier None Typical Low $25.12 Median $79.43 Typical High $79.43 | Professional | None | $25.12 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $123.03 | Professional | None | $44.67 | $61.66 | $123.03 |
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 $21.38 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $21.38 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $8.51 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $6.46 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.27 | $6.17 | $6.17 |
Where Connecticut sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 39th of 51
$57.54
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.