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 $389.05 Median $562.34 Typical High $562.34 | Professional | None | $389.05 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,412.54 | Facility | None | $912.01 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | UE · Used equipment | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $616.60 | Facility | None | $588.84 | $588.84 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
ConnectiCare Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
ConnectiCare Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,071.52 | Professional | None | $575.44 | $794.33 | $1,071.52 |
Health New England Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $660.69 | Professional | None | $436.52 | $575.44 | $660.69 |
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 $190.55 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $190.55 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $77.62 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $56.23 | $56.23 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 32nd of 51
$537
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.