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 $91.20 Median $100.00 Typical High $120.23 | Professional | None | $91.20 | $100.00 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $251.19 | Facility | None | $162.18 | $208.93 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | None | $114.82 | $114.82 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | UE · Used equipment | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Facility | None | $125.89 | $125.89 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
ConnectiCare Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
ConnectiCare Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $223.87 | Professional | None | $131.83 | $144.54 | $223.87 |
Health New England Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Health New England Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | None | $100.00 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $199.53 | Professional | None | $77.62 | $102.33 | $199.53 |
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 $44.67 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $10.00 |
Where Connecticut sits
The same service costs 2.1 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· 39th of 51
$115
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.