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 $1.20 Median $2.14 Typical High $2.82 | Professional | None | $1.20 | $2.14 | $2.82 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.05 | Professional | None | $0.89 | $0.89 | $1.05 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.09 Median $3.63 Typical High $4.68 | Professional | AU · Urologic/ostomy supply | $3.09 | $3.63 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | UE · Used equipment | $0.68 | $0.68 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
ConnectiCare Setting Professional Modifier None Typical Low $1.82 Median $5.37 Typical High $7.08 | Professional | None | $1.82 | $5.37 | $7.08 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $3.80 | Professional | None | $1.82 | $2.19 | $3.80 |
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 $1.00 Median $1.41 Typical High $1.41 | Professional | 52 · Reduced service | $1.00 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.39 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.30 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.20 | $0.28 | $0.28 |
Where Connecticut sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 50th of 51
$1.20
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.