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 $109.65 Median $109.65 Typical High $117.49 | Professional | None | $109.65 | $109.65 | $117.49 |
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 $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | RR · Rental | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Facility | None | $169.82 | $169.82 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
ConnectiCare Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
ConnectiCare Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $302.00 | Professional | None | $147.91 | $169.82 | $302.00 |
Health New England Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $154.88 | Professional | None | $85.11 | $112.20 | $154.88 |
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 $54.95 Median $54.95 Typical High $58.88 | Professional | 52 · Reduced service | $54.95 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $21.88 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.75 |
Where Connecticut sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 43rd of 51
$123
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.