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 $147.91 Median $169.82 Typical High $169.82 | Professional | None | $147.91 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $426.58 | Facility | None | $275.42 | $354.81 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | None | $194.98 | $204.17 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $213.80 | Facility | None | $204.17 | $204.17 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
ConnectiCare Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
ConnectiCare Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $380.19 | Professional | None | $223.87 | $239.88 | $380.19 |
Health New England Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Health New England Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $245.47 | Professional | None | $131.83 | $173.78 | $245.47 |
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 $75.86 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $16.98 |
Where Connecticut sits
The same service costs 3.3 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
$195
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.