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 $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $91.20 | Facility | None | $58.88 | $75.86 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $77.62 Typical High $91.20 | Professional | None | $40.74 | $77.62 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $7.76 Typical High $9.12 | Professional | RR · Rental | $5.89 | $7.76 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $58.88 Typical High $69.18 | Professional | UE · Used equipment | $44.67 | $58.88 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
ConnectiCare Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | None | $104.71 | $104.71 | $138.04 |
United Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $42.66 | Professional | None | $23.44 | $34.67 | $42.66 |
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 $16.98 Median $16.98 Typical High $25.70 | Professional | 52 · Reduced service | $16.98 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $10.23 | Professional | 53 · Discontinued | $6.76 | $6.76 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $7.76 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $5.13 |
Where Connecticut sits
The same service costs 2.9 times more in Montana than in Nebraska. 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
$54.95
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.