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 $123.03 Median $177.83 Typical High $177.83 | Professional | None | $123.03 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $371.54 Typical High $446.68 | Facility | None | $288.40 | $371.54 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | None | $169.82 | $169.82 | $177.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | RR · Rental | $16.98 | $16.98 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | UE · Used equipment | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
ConnectiCare Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $363.08 | Professional | None | $186.21 | $257.04 | $363.08 |
Health New England Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $213.80 | Professional | None | $138.04 | $181.97 | $213.80 |
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 $67.61 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $67.61 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
Where Connecticut sits
The same service costs 4.0 times more in Hawaii 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· 40th of 51
$174
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.