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 Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $162.18 | Professional | None | $93.33 | $123.03 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.47 Median $12.30 Typical High $15.85 | Professional | RR · Rental | $10.47 | $12.30 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $91.20 Typical High $117.49 | Professional | UE · Used equipment | $77.62 | $91.20 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
ConnectiCare Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $323.59 | Professional | None | $165.96 | $275.42 | $323.59 |
United Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $128.82 | Professional | None | $61.66 | $74.13 | $128.82 |
5 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 $38.90 Median $38.90 Typical High $53.70 | Professional | 52 · Reduced service | $38.90 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $21.38 | Professional | 53 · Discontinued | $15.85 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $10.47 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii 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· 23rd of 51
$105
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.