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 $53.70 Median $53.70 Typical High $70.79 | Professional | None | $53.70 | $53.70 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $144.54 | Facility | None | $93.33 | $120.23 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $97.72 Typical High $114.82 | Professional | None | $42.66 | $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 $54.95 Median $72.44 Typical High $85.11 | Professional | UE · Used equipment | $54.95 | $72.44 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
ConnectiCare Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | None | $112.20 | $112.20 | $147.91 |
United Setting Professional Modifier None Typical Low $25.12 Median $52.48 Typical High $66.07 | Professional | None | $25.12 | $52.48 | $66.07 |
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 $26.92 Median $26.92 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $14.13 | Professional | 53 · Discontinued | $10.72 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $7.08 |
Where Connecticut sits
The same service costs 3.2 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· 18th of 51
$74.13
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.