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 $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $91.20 | Facility | None | $58.88 | $75.86 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | None | $42.66 | $42.66 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Facility | None | $43.65 | $43.65 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
ConnectiCare Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
ConnectiCare Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $83.18 | Professional | None | $47.86 | $52.48 | $83.18 |
United Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $51.29 | Professional | None | $28.18 | $37.15 | $51.29 |
2 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 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $3.63 |
Where Connecticut sits
The same service costs 2.2 times more in Montana than in West Virginia. 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
$42.66
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.