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 $0.89 Median $1.15 Typical High $1.15 | Professional | None | $0.89 | $1.15 | $1.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.29 | Professional | None | $0.91 | $0.91 | $1.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | RR · Rental | $0.09 | $0.09 | $0.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.68 Typical High $0.95 | Professional | UE · Used equipment | $0.68 | $0.68 | $0.95 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
ConnectiCare Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
ConnectiCare Setting Professional Modifier None Typical Low $1.17 Median $1.29 Typical High $2.04 | Professional | None | $1.17 | $1.29 | $2.04 |
Health New England Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.89 Typical High $1.12 | Professional | None | $0.68 | $0.89 | $1.12 |
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 $0.45 Median $0.58 Typical High $0.58 | Professional | 52 · Reduced service | $0.45 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.18 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.18 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.13 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.09 | $0.12 | $0.12 |
Where Connecticut sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 47th of 51
$0.93
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.