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 $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $151.36 | Facility | None | $97.72 | $125.89 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $331.13 Typical High $331.13 | Professional | None | $72.44 | $331.13 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | RR · Rental | $33.11 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | UE · Used equipment | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
ConnectiCare Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
ConnectiCare Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $138.04 | Professional | None | $81.28 | $87.10 | $138.04 |
United Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $85.11 | Professional | None | $46.77 | $61.66 | $85.11 |
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 $27.54 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $27.54 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $10.96 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.13 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.50 | $6.03 | $6.03 |
Where Connecticut sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 36th of 51
$85.11
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.