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 $40.74 Median $41.69 Typical High $57.54 | Professional | None | $40.74 | $41.69 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $104.71 | Facility | None | $67.61 | $87.10 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | RR · Rental | $5.01 | $5.01 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $87.10 | Facility | None | $53.70 | $53.70 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
ConnectiCare Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
ConnectiCare Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $97.72 | Professional | None | $56.23 | $60.26 | $97.72 |
Health New England Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $83.18 | Professional | None | $33.88 | $42.66 | $83.18 |
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 $19.95 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $19.95 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $7.94 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.31 Typical High $6.61 | Professional | 55 · Aftercare only | $6.03 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $4.37 |
Where Connecticut sits
The same service costs 3.3 times more in Hawaii 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· 37th of 51
$50.12
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.