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 $112.20 Median $165.96 Typical High $165.96 | Professional | None | $112.20 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $426.58 | Facility | None | $275.42 | $354.81 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | None | $154.88 | $154.88 | $165.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | RR · Rental | $15.49 | $15.49 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Facility | None | $162.18 | $162.18 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
ConnectiCare Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $323.59 | Professional | None | $169.82 | $234.42 | $323.59 |
Health New England Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $199.53 | Professional | None | $131.83 | $173.78 | $199.53 |
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 $57.54 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $57.54 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $22.91 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.48 | $16.60 | $16.60 |
Where Connecticut sits
The same service costs 2.8 times more in Minnesota 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· 32nd of 51
$162
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.