How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2.04 Median $3.02 Typical High $3.02 | Professional | None | $2.04 | $3.02 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.39 | Professional | None | $3.02 | $3.02 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | RR · Rental | $0.30 | $0.30 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | UE · Used equipment | $2.24 | $2.24 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
ConnectiCare Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
ConnectiCare Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $5.37 | Professional | None | $3.09 | $3.31 | $5.37 |
Health New England Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Health New England Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.34 Typical High $4.17 | Professional | None | $1.74 | $2.34 | $4.17 |
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 $1.15 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.15 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.46 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.46 Typical High $0.46 | Professional | 55 · Aftercare only | $0.35 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.23 | $0.31 | $0.31 |
Where Connecticut sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 29th of 51
$3.02
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.