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 $162.18 Median $162.18 Typical High $194.98 | Professional | None | $162.18 | $162.18 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $416.87 | Facility | None | $263.03 | $346.74 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | None | $204.17 | $204.17 | $223.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | RR · Rental | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $501.19 | Professional | None | $218.78 | $251.19 | $501.19 |
Health New England Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $257.04 | Professional | None | $128.82 | $165.96 | $257.04 |
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 $81.28 Median $81.28 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | 53 · Discontinued | $32.36 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $19.50 |
Where Connecticut sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 41st of 51
$204
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.