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 $2.19 Median $3.24 Typical High $3.24 | Professional | None | $2.19 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.72 | Professional | None | $2.51 | $2.51 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | RR · Rental | $0.25 | $0.25 | $0.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | UE · Used equipment | $1.86 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
ConnectiCare Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.47 | Facility | None | $3.24 | $3.24 | $3.47 |
ConnectiCare Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $5.37 | Professional | None | $3.24 | $3.55 | $5.37 |
Health New England Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.51 Typical High $3.09 | Professional | None | $1.82 | $2.51 | $3.09 |
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 $1.23 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.23 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.49 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.37 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.25 | $0.32 | $0.32 |
Where Connecticut sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 46th of 51
$2.57
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.