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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.27 | Professional | None | $2.88 | $2.88 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $5.75 | Professional | None | $3.80 | $4.47 | $5.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.45 Typical High $0.56 | Professional | RR · Rental | $0.38 | $0.45 | $0.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.82 Median $3.39 Typical High $4.37 | Professional | UE · Used equipment | $2.82 | $3.39 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
ConnectiCare Setting Professional Modifier None Typical Low $6.03 Median $10.23 Typical High $20.89 | Professional | None | $6.03 | $10.23 | $20.89 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.69 Typical High $4.68 | Professional | None | $2.24 | $2.69 | $4.68 |
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 $1.45 Median $1.45 Typical High $1.95 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.78 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.14 Median $2.14 Typical High $2.95 | Professional | 54 · Surgery only | $2.14 | $2.14 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.59 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.38 |
Where Connecticut sits
The same service costs 3.8 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· 22nd of 51
$3.98
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.