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 $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $107.15 | Facility | None | $67.61 | $89.13 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $85.11 Typical High $100.00 | Professional | None | $40.74 | $85.11 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $8.51 Typical High $10.00 | Professional | RR · Rental | $6.46 | $8.51 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | UE · Used equipment | $48.98 | $64.57 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
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 $25.70 Median $38.90 Typical High $50.12 | Professional | None | $25.70 | $38.90 | $50.12 |
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 $19.50 Median $19.50 Typical High $27.54 | Professional | 52 · Reduced service | $19.50 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $10.96 | Professional | 53 · Discontinued | $7.94 | $7.94 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.50 |
Where Connecticut sits
The same service costs 2.6 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· 27th of 51
$57.54
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.