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 $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $109.65 | Facility | None | $70.79 | $91.20 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $97.72 Typical High $114.82 | Professional | None | $38.90 | $97.72 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $9.77 Typical High $11.48 | Professional | RR · Rental | $7.41 | $9.77 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $74.13 Typical High $87.10 | Professional | UE · Used equipment | $56.23 | $74.13 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
ConnectiCare Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | None | $102.33 | $102.33 | $134.90 |
United Setting Professional Modifier None Typical Low $10.96 Median $44.67 Typical High $51.29 | Professional | None | $10.96 | $44.67 | $51.29 |
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 $20.42 Median $20.42 Typical High $28.18 | Professional | 52 · Reduced service | $20.42 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $11.22 | Professional | 53 · Discontinued | $8.13 | $8.13 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $8.51 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.62 |
Where Connecticut sits
The same service costs 3.5 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· 25th of 51
$64.57
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.