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 $38.02 Median $41.69 Typical High $41.69 | Professional | None | $38.02 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $104.71 | Facility | None | $67.61 | $87.10 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $51.29 | Professional | None | $47.86 | $48.98 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | UE · Used equipment | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
ConnectiCare Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
ConnectiCare Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $91.20 | Professional | None | $56.23 | $60.26 | $91.20 |
United Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $58.88 | Professional | None | $32.36 | $42.66 | $58.88 |
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 $19.05 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $7.59 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.80 | $4.17 | $4.17 |
Where Connecticut sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 49th of 51
$47.86
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.