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 $27.54 Median $27.54 Typical High $45.71 | Professional | None | $27.54 | $27.54 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $61.66 Typical High $74.13 | Facility | None | $47.86 | $61.66 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $64.57 Typical High $75.86 | Professional | None | $33.11 | $64.57 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $6.46 Typical High $7.59 | Professional | RR · Rental | $4.90 | $6.46 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $48.98 Typical High $57.54 | Professional | UE · Used equipment | $37.15 | $48.98 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
ConnectiCare Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | None | $74.13 | $74.13 | $114.82 |
United Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $34.67 | Professional | None | $19.50 | $29.51 | $34.67 |
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 $13.80 Median $13.80 Typical High $22.91 | Professional | 52 · Reduced service | $13.80 | $13.80 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $9.12 | Professional | 53 · Discontinued | $5.50 | $5.50 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $6.92 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.57 |
Where Connecticut sits
The same service costs 2.6 times more in Montana than in Indiana. 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
$47.86
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.