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 $1.12 Median $1.66 Typical High $1.66 | Professional | None | $1.12 | $1.66 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.58 | Professional | None | $1.29 | $1.29 | $1.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | RR · Rental | $0.13 | $0.13 | $0.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $0.98 Typical High $1.38 | Professional | UE · Used equipment | $0.98 | $0.98 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.62 | Facility | None | $1.55 | $1.55 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
ConnectiCare Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $1.70 | Facility | None | $1.48 | $1.48 | $1.70 |
ConnectiCare Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $2.75 | Professional | None | $1.70 | $1.82 | $2.75 |
Health New England Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Health New England Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.29 Typical High $1.62 | Professional | None | $0.95 | $1.29 | $1.62 |
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 $0.65 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.65 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.25 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.19 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.13 | $0.17 | $0.17 |
Where Connecticut sits
The same service costs 2.3 times more in Kansas 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
$1.32
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.