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 $4,570.88 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,570.88 | $5,011.87 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $10,715.19 Typical High $12,882.50 | Facility | None | $8,128.31 | $10,715.19 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,025.60 Median $6,606.93 Typical High $6,760.83 | Professional | None | $6,025.60 | $6,606.93 | $6,760.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | RR · Rental | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | UE · Used equipment | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,943.28 | Facility | None | $7,585.78 | $7,585.78 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
ConnectiCare Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
ConnectiCare Setting Professional Modifier None Typical Low $6,309.57 Median $7,244.36 Typical High $10,471.29 | Professional | None | $6,309.57 | $7,244.36 | $10,471.29 |
Health New England Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $3,981.07 Median $5,128.61 Typical High $7,079.46 | Professional | None | $3,981.07 | $5,128.61 | $7,079.46 |
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 $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,290.87 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $457.09 | $501.19 | $501.19 |
Where Connecticut sits
The same service costs 2.1 times more in Montana 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· 30th of 51
$6,607
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.