How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.12 Median $0.19 Typical High $0.19 | Professional | None | $0.12 | $0.19 | $0.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | None | $25.70 | $25.70 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | RR · Rental | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | UE · Used equipment | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
ConnectiCare Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $0.06 Median $0.10 Typical High $0.10 | Professional | 52 · Reduced service | $0.06 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.02 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Connecticut sits
The same service costs 660.7 times more in Montana than in Louisiana. 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· 5th of 51
$25.70
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.