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 $169.82 Median $245.47 Typical High $245.47 | Professional | None | $169.82 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $616.60 | Facility | None | $398.11 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $302.00 | Professional | None | $275.42 | $281.84 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $27.54 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Facility | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
ConnectiCare Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $478.63 | Professional | None | $257.04 | $354.81 | $478.63 |
Health New England Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Health New England Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $323.59 | Professional | None | $190.55 | $251.19 | $323.59 |
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 $87.10 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $34.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.38 | $24.55 | $24.55 |
Where Connecticut sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 29th of 51
$275
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.