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 $30.20 Median $30.20 Typical High $45.71 | Professional | None | $30.20 | $30.20 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $67.61 Typical High $81.28 | Facility | None | $52.48 | $67.61 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $79.43 | Professional | None | $40.74 | $67.61 | $79.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.13 Median $6.76 Typical High $7.94 | Professional | RR · Rental | $5.13 | $6.76 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | UE · Used equipment | $38.90 | $51.29 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
ConnectiCare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | None | $91.20 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $20.42 Median $30.90 Typical High $38.02 | Professional | None | $20.42 | $30.90 | $38.02 |
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 $15.14 Median $15.14 Typical High $21.88 | Professional | 52 · Reduced service | $15.14 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | 53 · Discontinued | $6.03 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $4.37 |
Where Connecticut sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 26th of 51
$46.77
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.