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 $138.04 Median $138.04 Typical High $151.36 | Professional | None | $138.04 | $138.04 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $346.74 | Facility | None | $223.87 | $288.40 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | None | $169.82 | $169.82 | $177.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | RR · Rental | $16.98 | $16.98 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | UE · Used equipment | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Facility | None | $177.83 | $177.83 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
ConnectiCare Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $398.11 | Professional | None | $186.21 | $213.80 | $398.11 |
Health New England Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
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 $69.18 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $27.54 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $15.14 |
Where Connecticut sits
The same service costs 3.5 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· 38th of 51
$170
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.