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 $18,620.87 Median $21,877.62 Typical High $21,877.62 | Professional | None | $18,620.87 | $21,877.62 | $21,877.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $35,481.34 Median $45,708.82 Typical High $54,954.09 | Facility | None | $35,481.34 | $45,708.82 | $54,954.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $25,703.96 | Professional | None | $23,988.33 | $23,988.33 | $25,703.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $31,622.78 | Facility | None | $30,199.52 | $30,199.52 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
ConnectiCare Setting Facility Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
ConnectiCare Setting Professional Modifier None Typical Low $28,840.32 Median $31,622.78 Typical High $47,863.01 | Professional | None | $28,840.32 | $31,622.78 | $47,863.01 |
Health New England Setting Professional Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,118.86 | Professional | None | $25,118.86 | $25,118.86 | $25,118.86 |
United Setting Professional Modifier None Typical Low $17,378.01 Median $22,387.21 Typical High $29,512.09 | Professional | None | $17,378.01 | $22,387.21 | $29,512.09 |
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 $9,332.54 Median $10,964.78 Typical High $10,964.78 | Professional | 52 · Reduced service | $9,332.54 | $10,964.78 | $10,964.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,715.35 Median $4,365.16 Typical High $4,365.16 | Professional | 53 · Discontinued | $3,715.35 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,818.38 Median $3,311.31 Typical High $3,311.31 | Professional | 55 · Aftercare only | $2,818.38 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | 56 · Pre-op care only | $1,862.09 | $2,187.76 | $2,187.76 |
Where Connecticut sits
The same service costs 2.1 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· 35th of 51
$23,988
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.