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 $38.90 Median $42.66 Typical High $42.66 | Professional | None | $38.90 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $91.20 Typical High $109.65 | Facility | None | $69.18 | $91.20 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $56.23 | Professional | None | $51.29 | $54.95 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
ConnectiCare Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
ConnectiCare Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $100.00 | Professional | None | $57.54 | $61.66 | $100.00 |
Health New England Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Health New England Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $60.26 | Professional | None | $33.88 | $43.65 | $60.26 |
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 $19.50 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $19.50 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.76 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.89 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.27 |
Where Connecticut sits
The same service costs 2.8 times more in Kansas 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
$54.95
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.