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 $53.70 Median $74.13 Typical High $74.13 | Professional | None | $53.70 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $186.21 | Facility | None | $120.23 | $154.88 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | None | $69.18 | $69.18 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Facility | None | $85.11 | $85.11 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
ConnectiCare Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
ConnectiCare Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $151.36 | Professional | None | $77.62 | $107.15 | $151.36 |
Health New England Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $147.91 | Professional | None | $51.29 | $74.13 | $147.91 |
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 $26.92 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $26.92 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $10.72 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $7.94 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.37 | $7.41 | $7.41 |
Where Connecticut sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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· 35th of 51
$69.18
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.