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 $7,762.47 Median $9,772.37 Typical High $9,772.37 | Professional | None | $7,762.47 | $9,772.37 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,417.38 Typical High $24,547.09 | Facility | None | $15,848.93 | $20,417.38 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $11,481.54 | Professional | None | $10,715.19 | $10,715.19 | $11,481.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Facility | None | $12,589.25 | $12,589.25 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
ConnectiCare Setting Facility Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $13,182.57 | Facility | None | $13,182.57 | $13,182.57 | $13,182.57 |
ConnectiCare Setting Professional Modifier None Typical Low $11,481.54 Median $14,125.38 Typical High $19,952.62 | Professional | None | $11,481.54 | $14,125.38 | $19,952.62 |
Health New England Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $13,182.57 | Professional | None | $7,585.78 | $10,000.00 | $13,182.57 |
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 $4,265.80 Median $4,897.79 Typical High $4,897.79 | Professional | 52 · Reduced service | $4,265.80 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,949.84 Typical High $1,949.84 | Professional | 53 · Discontinued | $1,698.24 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | 55 · Aftercare only | $1,258.93 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 56 · Pre-op care only | $851.14 | $977.24 | $977.24 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in Florida. 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· 40th of 51
$10,715
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.