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 $18.62 Median $27.54 Typical High $27.54 | Professional | None | $18.62 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | RR · Rental | $1.91 | $1.91 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | UE · Used equipment | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
ConnectiCare Setting Professional Modifier None Typical Low $17.78 Median $53.70 Typical High $81.28 | Professional | None | $17.78 | $53.70 | $81.28 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $16.60 | Professional | None | $13.49 | $15.14 | $16.60 |
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 $10.47 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $10.47 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $4.27 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $3.16 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.09 | $2.82 | $2.82 |
Where Connecticut sits
The same service costs 3.2 times more in Hawaii 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· 44th of 51
$19.05
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.