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 $1.35 Median $2.00 Typical High $2.00 | Professional | None | $1.35 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.66 | Professional | None | $1.38 | $1.38 | $1.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | RR · Rental | $0.14 | $0.14 | $0.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | UE · Used equipment | $1.05 | $1.05 | $1.05 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.95 | Facility | None | $1.86 | $1.86 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
ConnectiCare Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
ConnectiCare Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $3.47 | Professional | None | $2.04 | $2.19 | $3.47 |
Health New England Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.55 Typical High $2.69 | Professional | None | $1.12 | $1.55 | $2.69 |
2 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 55 · Aftercare only Typical Low $0.23 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.23 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.15 | $0.20 | $0.20 |
Where Connecticut sits
The same service costs 3.0 times more in Hawaii 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
$1.55
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.