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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.61 | Professional | None | $4.47 | $4.47 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $9.12 | Professional | None | $5.89 | $6.92 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.59 Median $0.69 Typical High $0.89 | Professional | RR · Rental | $0.59 | $0.69 | $0.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $5.25 Typical High $6.76 | Professional | UE · Used equipment | $4.47 | $5.25 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
ConnectiCare Setting Professional Modifier None Typical Low $9.33 Median $15.85 Typical High $34.67 | Professional | None | $9.33 | $15.85 | $34.67 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $7.41 | Professional | None | $3.47 | $4.17 | $7.41 |
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 $2.24 Median $2.24 Typical High $3.02 | Professional | 52 · Reduced service | $2.24 | $2.24 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $1.23 | Professional | 53 · Discontinued | $0.89 | $0.89 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.39 Median $3.39 Typical High $4.57 | Professional | 54 · Surgery only | $3.39 | $3.39 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.91 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.62 |
Where Connecticut sits
The same service costs 4.1 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
$6.17
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.