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 $501.19 Median $575.44 Typical High $575.44 | Professional | None | $501.19 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,445.44 | Facility | None | $933.25 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | None | $660.69 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | RR · Rental | $66.07 | $66.07 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | UE · Used equipment | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
ConnectiCare Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
ConnectiCare Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,202.26 | Professional | None | $724.44 | $831.76 | $1,202.26 |
Health New England Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $812.83 | Professional | None | $446.68 | $588.84 | $812.83 |
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 $251.19 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $57.54 | $57.54 |
Where Connecticut sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 35th of 51
$661
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.