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 $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,513.56 | Professional | None | $912.01 | $1,412.54 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | RR · Rental | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | UE · Used equipment | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Facility | None | $1,479.11 | $1,479.11 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
ConnectiCare Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,819.70 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,318.26 | $1,778.28 |
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 $575.44 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $128.82 |
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· 44th of 51
$1,318
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.