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 $7,585.78 Median $9,120.11 Typical High $9,120.11 | Professional | None | $7,585.78 | $9,120.11 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $14,791.08 Median $19,054.61 Typical High $22,908.68 | Facility | None | $14,791.08 | $19,054.61 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $11,220.18 | Professional | None | $10,232.93 | $10,232.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | RR · Rental | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | UE · Used equipment | $7,762.47 | $7,762.47 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,302.69 | Facility | None | $11,748.98 | $11,748.98 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,511.38 | $11,748.98 |
ConnectiCare Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
ConnectiCare Setting Professional Modifier None Typical Low $11,220.18 Median $13,182.57 Typical High $19,054.61 | Professional | None | $11,220.18 | $13,182.57 | $19,054.61 |
Health New England Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
United Setting Professional Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $12,882.50 | Professional | None | $7,079.46 | $9,332.54 | $12,882.50 |
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 $3,981.07 Median $4,570.88 Typical High $4,570.88 | Professional | 52 · Reduced service | $3,981.07 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,584.89 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,584.89 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 55 · Aftercare only | $1,202.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 56 · Pre-op care only | $794.33 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 2.6 times more in Montana 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· 39th of 51
$10,233
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.