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 $13.49 Median $14.13 Typical High $14.13 | Professional | None | $13.49 | $14.13 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $29.51 Typical High $35.48 | Facility | None | $22.91 | $29.51 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $20.89 | Professional | None | $16.98 | $19.95 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | RR · Rental | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | UE · Used equipment | $14.79 | $14.79 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $19.50 | Facility | None | $18.62 | $18.62 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
ConnectiCare Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
ConnectiCare Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $34.67 | Professional | None | $19.05 | $20.89 | $34.67 |
Health New England Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.45 Typical High $19.95 | Professional | None | $11.22 | $14.45 | $19.95 |
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 $6.76 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $6.76 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.69 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.04 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.35 | $1.41 | $1.41 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 34th of 51
$18.62
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.