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 $281.84 Median $346.74 Typical High $346.74 | Professional | None | $281.84 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $891.25 | Facility | None | $562.34 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | None | $398.11 | $398.11 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | RR · Rental | $39.81 | $39.81 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Facility | None | $489.78 | $489.78 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
ConnectiCare Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
ConnectiCare Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $741.31 | Professional | None | $436.52 | $501.19 | $741.31 |
United Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $489.78 | Professional | None | $275.42 | $354.81 | $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 $147.91 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $34.67 | $34.67 |
Where Connecticut sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 38th of 51
$398
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.