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 $57.54 | Professional | None | $39.81 | $39.81 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $107.15 | Facility | None | $69.18 | $89.13 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $100.00 | Professional | None | $58.88 | $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 $109.65 Median $109.65 Typical High $141.25 | Professional | None | $109.65 | $109.65 | $141.25 |
United Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $50.12 | Professional | None | $25.70 | $39.81 | $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 $19.95 Median $19.95 Typical High $27.54 | Professional | 52 · Reduced service | $19.95 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.22 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $8.32 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.62 |
Where Connecticut sits
The same service costs 2.7 times more in Hawaii than in Indiana. 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· 23rd of 51
$58.88
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.