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 $1,862.09 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,862.09 | $1,905.46 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $4,897.79 | Facility | None | $3,162.28 | $4,073.80 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,019.95 | $3,311.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | RR · Rental | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | UE · Used equipment | $2,290.87 | $2,290.87 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Facility | None | $3,019.95 | $3,019.95 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
ConnectiCare Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,570.40 | $2,754.23 | $4,570.88 |
Health New England Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,995.26 | $3,019.95 |
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 $933.25 Median $954.99 Typical High $1,023.29 | Professional | 52 · Reduced service | $933.25 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $389.05 Typical High $407.38 | Professional | 53 · Discontinued | $371.54 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $302.00 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $190.55 Typical High $204.17 | Professional | 56 · Pre-op care only | $186.21 | $190.55 | $204.17 |
Where Connecticut sits
The same service costs 2.4 times more in Hawaii than in West Virginia. 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· 24th of 51
$3,020
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.