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 $2.29 Median $3.31 Typical High $3.31 | Professional | None | $2.29 | $3.31 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | None | $2.57 | $2.57 | $2.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | RR · Rental | $0.26 | $0.26 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | UE · Used equipment | $1.95 | $1.95 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.31 | Facility | None | $3.16 | $3.16 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | None | $2.63 | $2.63 | $3.16 |
ConnectiCare Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
ConnectiCare Setting Professional Modifier None Typical Low $3.39 Median $3.72 Typical High $5.89 | Professional | None | $3.39 | $3.72 | $5.89 |
Health New England Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.57 Typical High $3.24 | Professional | None | $1.91 | $2.57 | $3.24 |
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 $1.26 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $1.26 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.51 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.38 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.25 | $0.33 | $0.33 |
Where Connecticut sits
The same service costs 2.1 times more in Hawaii than in Connecticut. 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· 51st of 51
$2.63
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.