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 $117.49 Median $125.89 Typical High $151.36 | Professional | None | $117.49 | $125.89 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $151.36 | Professional | None | $91.20 | $141.25 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | RR · Rental | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | UE · Used equipment | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Facility | None | $194.98 | $194.98 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
ConnectiCare Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $288.40 | Professional | None | $169.82 | $181.97 | $288.40 |
Health New England Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $177.83 | Professional | None | $97.72 | $128.82 | $177.83 |
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 $17.38 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $12.59 |
Where Connecticut sits
The same service costs 2.6 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
$141
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.