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 $186.21 Median $269.15 Typical High $269.15 | Professional | None | $186.21 | $269.15 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $269.15 | Professional | None | $147.91 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | RR · Rental | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | UE · Used equipment | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Facility | None | $371.54 | $371.54 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
ConnectiCare Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
ConnectiCare Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $562.34 | Professional | None | $275.42 | $380.19 | $562.34 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $323.59 | Professional | None | $213.80 | $281.84 | $323.59 |
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 $93.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $27.54 |
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· 45th of 51
$269
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.