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 $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
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 $58.88 Median $102.33 Typical High $120.23 | Professional | None | $58.88 | $102.33 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.76 Median $10.23 Typical High $12.02 | Professional | RR · Rental | $7.76 | $10.23 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $75.86 Typical High $91.20 | Professional | UE · Used equipment | $58.88 | $75.86 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
ConnectiCare Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
United Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $67.61 | Professional | None | $30.90 | $53.70 | $67.61 |
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 $37.15 | Professional | 52 · Reduced service | $26.92 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $14.79 | Professional | 53 · Discontinued | $10.72 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $7.41 |
Where Connecticut sits
The same service costs 2.9 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· 24th of 51
$75.86
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.