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 $229.09 Median $257.04 Typical High $257.04 | Professional | None | $229.09 | $257.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $302.00 | Professional | None | $186.21 | $281.84 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | RR · Rental | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | UE · Used equipment | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Facility | None | $416.87 | $416.87 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
ConnectiCare Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $588.84 | Professional | None | $338.84 | $371.54 | $588.84 |
Health New England Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | None | $199.53 | $263.03 | $354.81 |
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 $114.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $25.70 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in New York. 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· 48th of 51
$282
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.