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 $4.17 Median $6.17 Typical High $6.17 | Professional | None | $4.17 | $6.17 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.90 | Professional | None | $4.07 | $4.07 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | RR · Rental | $0.41 | $0.41 | $0.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | UE · Used equipment | $3.09 | $3.09 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $6.17 | Facility | None | $5.75 | $5.75 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
ConnectiCare Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
ConnectiCare Setting Professional Modifier None Typical Low $6.31 Median $6.76 Typical High $10.96 | Professional | None | $6.31 | $6.76 | $10.96 |
Health New England Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.79 Typical High $8.51 | Professional | None | $3.55 | $4.79 | $8.51 |
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 $2.19 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.19 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $0.87 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.65 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.43 | $0.62 | $0.62 |
Where Connecticut sits
The same service costs 2.5 times more in Montana than in New Hampshire. 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· 49th 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.