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 $154.88 Median $218.78 Typical High $218.78 | Professional | None | $154.88 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $549.54 | Facility | None | $354.81 | $457.09 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | None | $218.78 | $218.78 | $234.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
ConnectiCare Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
ConnectiCare Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $436.52 | Professional | None | $234.42 | $309.03 | $436.52 |
Health New England Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $269.15 | Professional | None | $169.82 | $223.87 | $269.15 |
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 $77.62 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $77.62 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $23.44 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $21.88 | $21.88 |
Where Connecticut sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 36th of 51
$219
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.