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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | None | $10.47 | $10.47 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $21.38 | Professional | None | $13.80 | $16.22 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.38 Median $1.62 Typical High $2.09 | Professional | RR · Rental | $1.38 | $1.62 | $2.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.47 Median $12.30 Typical High $15.85 | Professional | UE · Used equipment | $10.47 | $12.30 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
ConnectiCare Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $39.81 | Professional | None | $21.88 | $37.15 | $39.81 |
United Setting Professional Modifier None Typical Low $8.13 Median $9.77 Typical High $17.38 | Professional | None | $8.13 | $9.77 | $17.38 |
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 $5.25 Median $5.25 Typical High $6.92 | Professional | 52 · Reduced service | $5.25 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.75 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | 54 · Surgery only | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.04 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.38 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii 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· 20th of 51
$14.45
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.