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 $64.57 Median $64.57 Typical High $93.33 | Professional | None | $64.57 | $64.57 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $138.04 | Professional | None | $89.13 | $117.49 | $138.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $11.75 Typical High $13.80 | Professional | RR · Rental | $8.91 | $11.75 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $67.61 Median $89.13 Typical High $104.71 | Professional | UE · Used equipment | $67.61 | $89.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
ConnectiCare Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | None | $158.49 | $158.49 | $208.93 |
Health New England Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Facility | None | $169.82 | $169.82 | $257.04 |
United Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $97.72 | Professional | None | $58.88 | $70.79 | $97.72 |
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 $32.36 Median $32.36 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $18.62 | Professional | 53 · Discontinued | $12.88 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $9.33 |
Where Connecticut sits
The same service costs 3.4 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· 34th of 51
$93.33
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.