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 $309.03 Median $446.68 Typical High $446.68 | Professional | None | $309.03 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $1,122.02 | Facility | None | $724.44 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | None | $416.87 | $416.87 | $446.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | RR · Rental | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | UE · Used equipment | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
ConnectiCare Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
ConnectiCare Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $912.01 | Professional | None | $457.09 | $630.96 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | None | $354.81 | $457.09 | $537.03 |
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 $154.88 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $61.66 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $44.67 |
Where Connecticut sits
The same service costs 3.0 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· 40th of 51
$417
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.