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 $35.48 Median $35.48 Typical High $56.23 | Professional | None | $35.48 | $35.48 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $95.50 | Facility | None | $60.26 | $77.62 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $100.00 | Professional | None | $64.57 | $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 $114.82 Median $114.82 Typical High $151.36 | Professional | None | $114.82 | $114.82 | $151.36 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $44.67 | Professional | None | $32.36 | $38.02 | $44.67 |
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 $17.38 Median $17.38 Typical High $28.18 | Professional | 52 · Reduced service | $17.38 | $17.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $11.22 | Professional | 53 · Discontinued | $7.08 | $7.08 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $8.32 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.62 |
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· 19th of 51
$64.57
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.