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 $371.54 Median $398.11 Typical High $398.11 | Professional | None | $371.54 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,000.00 | Facility | None | $645.65 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | None | $389.05 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | RR · Rental | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
ConnectiCare Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
ConnectiCare Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $954.99 | Professional | None | $537.03 | $575.44 | $954.99 |
Health New England Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $537.03 | Professional | None | $316.23 | $407.38 | $537.03 |
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 $186.21 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $39.81 |
Where Connecticut sits
The same service costs 2.8 times more in Wisconsin 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· 44th of 51
$389
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.