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 $107.15 Median $107.15 Typical High $141.25 | Professional | None | $107.15 | $107.15 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $288.40 | Facility | None | $186.21 | $239.88 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $229.09 | Professional | None | $97.72 | $194.98 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.79 Median $19.50 Typical High $22.91 | Professional | RR · Rental | $14.79 | $19.50 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $112.20 Median $144.54 Typical High $173.78 | Professional | UE · Used equipment | $112.20 | $144.54 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
ConnectiCare Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | None | $263.03 | $263.03 | $346.74 |
United Setting Professional Modifier None Typical Low $32.36 Median $104.71 Typical High $134.90 | Professional | None | $32.36 | $104.71 | $134.90 |
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 $53.70 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | 53 · Discontinued | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $20.89 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $14.13 |
Where Connecticut sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 18th of 51
$148
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.