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 $10.47 Median $10.47 Typical High $10.96 | Professional | None | $10.47 | $10.47 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $21.88 Typical High $26.30 | Facility | None | $16.98 | $21.88 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $14.79 | Professional | None | $12.02 | $13.49 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | RR · Rental | $1.35 | $1.35 | $1.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | UE · Used equipment | $10.23 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.14 | Facility | None | $14.45 | $14.45 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
ConnectiCare Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
ConnectiCare Setting Professional Modifier None Typical Low $14.13 Median $16.22 Typical High $28.18 | Professional | None | $14.13 | $16.22 | $28.18 |
Health New England Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Health New England Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.72 Typical High $14.45 | Professional | None | $8.13 | $10.72 | $14.45 |
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 $5.25 Median $5.25 Typical High $5.50 | Professional | 52 · Reduced service | $5.25 | $5.25 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $1.62 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.10 |
Where Connecticut sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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
$13.49
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.