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 $281.84 Typical High $309.03 | Professional | None | $281.84 | $281.84 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $724.44 | Facility | None | $457.09 | $602.56 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | None | $354.81 | $354.81 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | RR · Rental | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | UE · Used equipment | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
ConnectiCare Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
ConnectiCare Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $794.33 | Professional | None | $380.19 | $436.52 | $794.33 |
Health New England Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $436.52 | Professional | None | $223.87 | $288.40 | $436.52 |
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 $141.25 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $30.90 |
Where Connecticut sits
The same service costs 3.0 times more in Hawaii than in Washington, DC. 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· 46th of 51
$355
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.