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 $100.00 Median $109.65 Typical High $112.20 | Professional | None | $100.00 | $109.65 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $275.42 | Facility | None | $177.83 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | None | $138.04 | $138.04 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | RR · Rental | $13.80 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
ConnectiCare Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
ConnectiCare Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $251.19 | Professional | None | $144.54 | $158.49 | $251.19 |
Health New England Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $169.82 | Professional | None | $85.11 | $112.20 | $169.82 |
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 $50.12 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $50.12 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $19.95 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $11.22 |
Where Connecticut sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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
$138
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.