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 $8.91 Median $12.88 Typical High $12.88 | Professional | None | $8.91 | $12.88 | $12.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $26.92 Typical High $32.36 | Facility | None | $20.89 | $26.92 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | None | $11.48 | $11.48 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | RR · Rental | $1.15 | $1.15 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | UE · Used equipment | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.13 | Facility | None | $13.49 | $13.49 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
ConnectiCare Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
ConnectiCare Setting Professional Modifier None Typical Low $13.18 Median $17.78 Typical High $26.30 | Professional | None | $13.18 | $17.78 | $26.30 |
Health New England Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.59 Typical High $25.12 | Professional | None | $8.91 | $12.59 | $25.12 |
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 $4.68 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $4.68 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $1.86 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.41 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.93 | $1.29 | $1.29 |
Where Connecticut sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 39th of 51
$11.48
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.