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 Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $12.02 | Professional | None | $8.71 | $8.71 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $17.38 | Professional | None | $11.48 | $13.49 | $17.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.12 Median $1.35 Typical High $1.74 | Professional | RR · Rental | $1.12 | $1.35 | $1.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.51 Median $10.00 Typical High $12.88 | Professional | UE · Used equipment | $8.51 | $10.00 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
ConnectiCare Setting Professional Modifier None Typical Low $18.20 Median $30.20 Typical High $53.70 | Professional | None | $18.20 | $30.20 | $53.70 |
United Setting Professional Modifier None Typical Low $6.76 Median $8.13 Typical High $14.13 | Professional | None | $6.76 | $8.13 | $14.13 |
5 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 $4.37 Median $4.37 Typical High $5.89 | Professional | 52 · Reduced service | $4.37 | $4.37 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $2.34 | Professional | 53 · Discontinued | $1.74 | $1.74 | $2.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.46 Median $6.46 Typical High $8.71 | Professional | 54 · Surgery only | $6.46 | $6.46 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.78 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $1.17 |
Where Connecticut sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 23rd of 51
$11.75
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.