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 $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $851.14 | Facility | None | $549.54 | $707.95 | $851.14 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | UE · Used equipment | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Facility | None | $436.52 | $436.52 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $794.33 | Professional | None | $446.68 | $489.78 | $794.33 |
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 $263.03 Median $346.74 Typical High $524.81 | Professional | None | $263.03 | $346.74 | $524.81 |
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 $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $33.88 |
Where Connecticut sits
The same service costs 2.8 times more in Montana than in Florida. 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.