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 $316.23 Median $346.74 Typical High $346.74 | Professional | None | $316.23 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $870.96 | Facility | None | $562.34 | $724.44 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $467.74 | Professional | None | $446.68 | $457.09 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | UE · Used equipment | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Facility | None | $446.68 | $446.68 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
ConnectiCare Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
ConnectiCare Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $794.33 | Professional | None | $457.09 | $489.78 | $794.33 |
Health New England Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $524.81 | Professional | None | $269.15 | $354.81 | $524.81 |
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 $158.49 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $31.62 | $34.67 | $34.67 |
Where Connecticut sits
The same service costs 2.8 times more in Iowa 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· 29th of 51
$457
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.