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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $81.28 | Professional | None | $46.77 | $61.66 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $6.17 Typical High $7.94 | Professional | RR · Rental | $5.25 | $6.17 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $45.71 Typical High $58.88 | Professional | UE · Used equipment | $38.90 | $45.71 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
ConnectiCare Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $162.18 | Professional | None | $83.18 | $138.04 | $162.18 |
United Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $64.57 | Professional | None | $30.90 | $37.15 | $64.57 |
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 $19.50 Median $19.50 Typical High $26.92 | Professional | 52 · Reduced service | $19.50 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | 54 · Surgery only | $29.51 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.94 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.25 |
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
$52.48
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.