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 $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,454.71 | Facility | None | $1,584.89 | $2,041.74 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | RR · Rental | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | UE · Used equipment | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Facility | None | $1,318.26 | $1,318.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
ConnectiCare Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,380.38 | $2,137.96 |
Health New England Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | None | $758.58 | $1,000.00 | $1,380.38 |
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 $436.52 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Where Connecticut sits
The same service costs 3.0 times more in Kansas 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· 36th of 51
$1,122
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.