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 $14.13 Median $14.13 Typical High $17.38 | Professional | None | $14.13 | $14.13 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $31.62 Typical High $38.02 | Facility | None | $24.55 | $31.62 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $25.70 Typical High $30.20 | Professional | None | $19.50 | $25.70 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $2.57 Typical High $3.02 | Professional | RR · Rental | $1.95 | $2.57 | $3.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $19.50 Typical High $22.91 | Professional | UE · Used equipment | $14.79 | $19.50 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
ConnectiCare Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | None | $33.88 | $33.88 | $44.67 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.14 Typical High $18.20 | Professional | None | $11.75 | $15.14 | $18.20 |
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 $7.08 Median $7.08 Typical High $8.71 | Professional | 52 · Reduced service | $7.08 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.63 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.74 |
Where Connecticut sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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· 20th of 51
$19.50
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.