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 $1.29 Median $1.70 Typical High $1.70 | Professional | None | $1.29 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | RR · Rental | $0.12 | $0.12 | $0.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | UE · Used equipment | $0.87 | $0.87 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
ConnectiCare Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $4.90 | Professional | None | $2.82 | $3.80 | $4.90 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.32 Typical High $2.29 | Professional | None | $1.10 | $1.32 | $2.29 |
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 $0.65 Median $0.85 Typical High $0.85 | Professional | 52 · Reduced service | $0.65 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.34 Typical High $0.34 | Professional | 53 · Discontinued | $0.26 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.19 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.13 | $0.17 | $0.17 |
Where Connecticut sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 39th of 51
$1.32
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.