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 $0.83 Median $0.83 Typical High $0.89 | Professional | None | $0.83 | $0.83 | $0.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.52 Median $0.62 Typical High $0.68 | Professional | None | $0.52 | $0.62 | $0.68 |
United Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $107.15 | Professional | None | $43.65 | $66.07 | $107.15 |
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 $0.42 Median $0.42 Typical High $0.45 | Professional | 52 · Reduced service | $0.42 | $0.42 | $0.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.09 |
Where Connecticut sits
The same service costs 177.8 times more in Texas than in Georgia. 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· 50th of 51
$0.62
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.