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 $27.54 Median $32.36 Typical High $32.36 | Professional | None | $27.54 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $69.18 Typical High $83.18 | Facility | None | $53.70 | $69.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | None | $33.11 | $33.11 | $35.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | RR · Rental | $3.31 | $3.31 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
ConnectiCare Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
ConnectiCare Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $72.44 | Professional | None | $42.66 | $46.77 | $72.44 |
Health New England Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $42.66 | Professional | None | $25.70 | $33.88 | $42.66 |
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 $13.80 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $13.80 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.62 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.17 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.82 | $3.24 | $3.24 |
Where Connecticut sits
The same service costs 2.5 times more in Hawaii 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· 40th of 51
$33.11
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.