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 $186.21 Median $199.53 Typical High $204.17 | Professional | None | $186.21 | $199.53 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $512.86 | Facility | None | $331.13 | $426.58 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | None | $218.78 | $218.78 | $234.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
ConnectiCare Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
ConnectiCare Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $524.81 | Professional | None | $269.15 | $309.03 | $524.81 |
Health New England Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $281.84 | Professional | None | $158.49 | $208.93 | $281.84 |
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 $97.72 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $20.42 |
Where Connecticut sits
The same service costs 2.7 times more in Montana 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· 44th of 51
$219
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.