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 $177.83 Median $263.03 Typical High $263.03 | Professional | None | $177.83 | $263.03 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $257.04 | Professional | None | $141.25 | $245.47 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $263.03 | Facility | None | $251.19 | $251.19 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | None | $199.53 | $199.53 | $251.19 |
ConnectiCare Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
ConnectiCare Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $537.03 | Professional | None | $269.15 | $371.54 | $537.03 |
United Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $309.03 | Professional | None | $204.17 | $269.15 | $309.03 |
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 $89.13 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.78 | $26.30 | $26.30 |
Where Connecticut sits
The same service costs 3.4 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· 40th of 51
$245
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.