How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.21 Median $0.40 Typical High $0.40 | Professional | None | $0.21 | $0.40 | $0.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.25 | Professional | None | $0.21 | $0.21 | $0.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | UE · Used equipment | $0.16 | $0.16 | $0.16 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
ConnectiCare Setting Professional Modifier None Typical Low $0.58 Median $0.83 Typical High $1.10 | Professional | None | $0.58 | $0.83 | $1.10 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.31 Typical High $0.54 | Professional | None | $0.26 | $0.31 | $0.54 |
6 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 $0.14 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.14 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.05 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.04 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.06 | $0.17 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.98 Typical High $1.10 | Professional | RR · Rental | $0.10 | $0.98 | $1.10 |
Where Connecticut sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 46th of 51
$0.28
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.