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 $13.18 Median $16.22 Typical High $16.22 | Professional | None | $13.18 | $16.22 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $33.88 Typical High $40.74 | Facility | None | $26.30 | $33.88 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $16.60 | Professional | None | $15.49 | $15.85 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | RR · Rental | $1.55 | $1.55 | $1.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | UE · Used equipment | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $17.38 | Facility | None | $16.60 | $16.60 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
ConnectiCare Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
ConnectiCare Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $33.88 | Professional | None | $20.42 | $23.44 | $33.88 |
Health New England Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $19.05 | Professional | None | $12.59 | $16.60 | $19.05 |
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 $6.61 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $6.61 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $2.63 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.32 | $1.62 | $1.62 |
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· 33rd of 51
$15.85
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.