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 $8.51 Median $9.12 Typical High $10.72 | Professional | None | $8.51 | $9.12 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | None | $14.13 | $14.13 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | RR · Rental | $1.41 | $1.41 | $1.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | UE · Used equipment | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
ConnectiCare Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | None | $22.91 | $22.91 | $45.71 |
Health New England Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Health New England Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $6.31 Median $8.91 Typical High $14.79 | Professional | None | $6.31 | $8.91 | $14.79 |
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 $3.80 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $3.80 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.51 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.17 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.79 | $0.91 | $0.91 |
Where Connecticut sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 26th of 51
$14.13
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.