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 $4,365.16 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,365.16 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $5,888.44 | Professional | None | $3,388.44 | $4,897.79 | $5,888.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | RR · Rental | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,623.41 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
ConnectiCare Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
ConnectiCare Setting Professional Modifier None Typical Low $6,456.54 Median $6,918.31 Typical High $10,964.78 | Professional | None | $6,456.54 | $6,918.31 | $10,964.78 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $4,897.79 Typical High $7,079.46 | Professional | None | $3,715.35 | $4,897.79 | $7,079.46 |
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 $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,187.76 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $436.52 | $478.63 | $478.63 |
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· 43rd of 51
$4,898
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.