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 $0.46 Median $0.62 Typical High $0.62 | Professional | None | $0.46 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.23 Median $0.31 Typical High $0.31 | Professional | 52 · Reduced service | $0.23 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.09 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.09 | $0.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | UE · Used equipment | $0.32 | $0.32 | $0.32 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
ConnectiCare Setting Professional Modifier None Typical Low $1.02 Median $1.38 Typical High $1.78 | Professional | None | $1.02 | $1.38 | $1.78 |
United Setting Professional Modifier None Typical Low $0.40 Median $0.48 Typical High $0.83 | Professional | None | $0.40 | $0.48 | $0.83 |
1 more rate 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 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
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· 46th of 51
$0.48
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.