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 $229.09 Median $245.47 Typical High $245.47 | Professional | None | $229.09 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $616.60 | Facility | None | $398.11 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | None | $281.84 | $281.84 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | RR · Rental | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Facility | None | $354.81 | $354.81 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
ConnectiCare Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
ConnectiCare Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $616.60 | Professional | None | $323.59 | $363.08 | $616.60 |
Health New England Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $489.78 | Professional | None | $190.55 | $251.19 | $489.78 |
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 $117.49 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $47.86 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $24.55 |
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· 29th of 51
$282
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.