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 $58.88 | Professional | None | $39.81 | $39.81 | $58.88 |
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 $41.69 Median $95.50 Typical High $112.20 | Professional | None | $41.69 | $95.50 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.24 Median $9.55 Typical High $11.22 | Professional | RR · Rental | $7.24 | $9.55 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $53.70 Median $70.79 Typical High $83.18 | Professional | UE · Used equipment | $53.70 | $70.79 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
ConnectiCare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $141.25 | Professional | None | $91.20 | $91.20 | $141.25 |
United Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $50.12 | Professional | None | $28.18 | $42.66 | $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 $29.51 | Professional | 52 · Reduced service | $19.50 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.75 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.71 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.89 |
Where Connecticut sits
The same service costs 2.4 times more in Hawaii 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
$67.61
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.