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 $4.47 Median $5.89 Typical High $5.89 | Professional | None | $4.47 | $5.89 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.92 | Professional | None | $4.57 | $4.57 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | RR · Rental | $0.46 | $0.46 | $0.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | UE · Used equipment | $3.39 | $3.39 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
ConnectiCare Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Facility | None | $5.89 | $5.89 | $6.17 |
ConnectiCare Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $9.77 | Professional | None | $5.89 | $6.31 | $9.77 |
Health New England Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.57 Typical High $5.62 | Professional | None | $3.31 | $4.57 | $5.62 |
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 $2.24 Median $2.95 Typical High $2.95 | Professional | 52 · Reduced service | $2.24 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $1.17 Typical High $1.17 | Professional | 53 · Discontinued | $0.89 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.68 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.59 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.45 | $0.59 | $0.59 |
Where Connecticut sits
The same service costs 2.3 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
$4.68
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.