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 $0.65 Median $0.65 Typical High $0.95 | Professional | None | $0.65 | $0.65 | $0.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.72 Typical High $0.85 | Professional | None | $0.62 | $0.72 | $0.85 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $0.85 | Professional | None | $0.38 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.48 Typical High $2.69 | Professional | None | $0.93 | $1.48 | $2.69 |
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 $0.33 Median $0.33 Typical High $0.36 | Professional | 52 · Reduced service | $0.33 | $0.33 | $0.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Connecticut sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 51st of 51
$0.72
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.