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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $4.17 | Professional | None | $3.02 | $3.02 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $4.68 Typical High $6.31 | Professional | None | $3.63 | $4.68 | $6.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.47 Typical High $0.60 | Professional | RR · Rental | $0.40 | $0.47 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.55 Typical High $4.57 | Professional | UE · Used equipment | $3.02 | $3.55 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
ConnectiCare Setting Professional Modifier None Typical Low $6.31 Median $10.72 Typical High $16.98 | Professional | None | $6.31 | $10.72 | $16.98 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.82 Typical High $5.01 | Professional | None | $2.34 | $2.82 | $5.01 |
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 $1.51 Median $1.51 Typical High $2.04 | Professional | 52 · Reduced service | $1.51 | $1.51 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.83 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $2.29 Typical High $3.09 | Professional | 54 · Surgery only | $2.29 | $2.29 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.62 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.40 |
Where Connecticut sits
The same service costs 3.0 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· 24th of 51
$4.07
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.