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 $70.79 Median $74.13 Typical High $74.13 | Professional | None | $70.79 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $190.55 | Facility | None | $120.23 | $154.88 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | None | $93.33 | $93.33 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | RR · Rental | $9.33 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | UE · Used equipment | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
ConnectiCare Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
ConnectiCare Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $173.78 | Professional | None | $100.00 | $107.15 | $173.78 |
Health New England Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $114.82 | Professional | None | $58.88 | $75.86 | $114.82 |
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 $34.67 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.13 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $7.41 |
Where Connecticut sits
The same service costs 2.9 times more in Montana than in Florida. 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· 34th of 51
$93.33
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.