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 $3.63 Median $5.37 Typical High $5.37 | Professional | None | $3.63 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | RR · Rental | $0.37 | $0.37 | $0.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | UE · Used equipment | $2.75 | $2.75 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
ConnectiCare Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $15.49 | Professional | None | $8.91 | $12.02 | $15.49 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.07 Typical High $7.24 | Professional | None | $3.47 | $4.07 | $7.24 |
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 $2.04 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.04 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $0.81 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.62 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.40 | $0.52 | $0.52 |
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· 45th of 51
$4.07
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.