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 $1.95 Median $2.88 Typical High $2.88 | Professional | None | $1.95 | $2.88 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.69 | Professional | None | $2.24 | $2.24 | $2.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | RR · Rental | $0.23 | $0.23 | $0.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | UE · Used equipment | $1.70 | $1.70 | $1.70 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.82 | Facility | None | $2.69 | $2.69 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
ConnectiCare Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
ConnectiCare Setting Professional Modifier None Typical Low $2.88 Median $3.09 Typical High $5.01 | Professional | None | $2.88 | $3.09 | $5.01 |
Health New England Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.24 Typical High $3.89 | Professional | None | $1.62 | $2.24 | $3.89 |
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 $1.07 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.07 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.42 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.32 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.21 | $0.28 | $0.28 |
Where Connecticut sits
The same service costs 2.1 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
$2.24
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.