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 $2.88 Median $4.27 Typical High $4.27 | Professional | None | $2.88 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.68 | Professional | None | $3.31 | $3.31 | $4.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | RR · Rental | $0.33 | $0.33 | $0.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | UE · Used equipment | $2.51 | $2.51 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.17 | Facility | None | $3.98 | $3.98 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
ConnectiCare Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.37 | Facility | None | $4.07 | $4.07 | $4.37 |
ConnectiCare Setting Professional Modifier None Typical Low $4.37 Median $4.68 Typical High $7.08 | Professional | None | $4.37 | $4.68 | $7.08 |
Health New England Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.31 Typical High $4.07 | Professional | None | $2.40 | $3.31 | $4.07 |
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 $1.62 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $1.62 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.65 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.49 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.32 | $0.43 | $0.43 |
Where Connecticut sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$3.39
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.