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 $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $229.09 | Facility | None | $147.91 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $181.97 | Professional | None | $117.49 | $154.88 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $15.49 Typical High $18.20 | Professional | RR · Rental | $11.75 | $15.49 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $117.49 Typical High $138.04 | Professional | UE · Used equipment | $89.13 | $117.49 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
ConnectiCare Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | None | $190.55 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $32.36 Median $85.11 Typical High $107.15 | Professional | None | $32.36 | $85.11 | $107.15 |
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 $42.66 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.23 |
Where Connecticut sits
The same service costs 3.0 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· 17th of 51
$117
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.