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 $48.98 Median $48.98 Typical High $69.18 | Professional | None | $48.98 | $48.98 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $131.83 | Facility | None | $85.11 | $109.65 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $125.89 | Professional | None | $58.88 | $107.15 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $8.13 | $10.72 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $60.26 Median $79.43 Typical High $93.33 | Professional | UE · Used equipment | $60.26 | $79.43 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
ConnectiCare Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $162.18 | Professional | None | $123.03 | $123.03 | $162.18 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $63.10 | Professional | None | $32.36 | $48.98 | $63.10 |
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 $24.55 Median $24.55 Typical High $34.67 | Professional | 52 · Reduced service | $24.55 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $13.80 | Professional | 53 · Discontinued | $9.77 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $10.23 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $6.92 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in Missouri. 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
$72.44
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.