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 $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $831.76 | Facility | None | $537.03 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | RR · Rental | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | UE · Used equipment | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
ConnectiCare Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
ConnectiCare Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $741.31 | Professional | None | $436.52 | $467.74 | $741.31 |
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 $257.04 Median $338.84 Typical High $478.63 | Professional | None | $257.04 | $338.84 | $478.63 |
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 $147.91 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $32.36 |
Where Connecticut sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 34th of 51
$407
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.