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 $1.07 Median $1.58 Typical High $1.66 | Professional | None | $1.07 | $1.58 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | RR · Rental | $0.11 | $0.11 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | UE · Used equipment | $0.81 | $0.81 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
ConnectiCare Setting Professional Modifier None Typical Low $2.40 Median $3.55 Typical High $4.57 | Professional | None | $2.40 | $3.55 | $4.57 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $2.14 | Professional | None | $1.02 | $1.23 | $2.14 |
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 $0.60 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.60 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.24 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.18 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.12 | $0.16 | $0.16 |
Where Connecticut sits
The same service costs 2.6 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· 49th of 51
$1.23
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.