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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $13.80 | Professional | None | $8.13 | $8.13 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $12.59 Typical High $16.98 | Professional | None | $9.55 | $12.59 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.26 Typical High $1.62 | Professional | RR · Rental | $1.07 | $1.26 | $1.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $9.55 Typical High $12.02 | Professional | UE · Used equipment | $7.94 | $9.55 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
ConnectiCare Setting Professional Modifier None Typical Low $16.98 Median $28.84 Typical High $72.44 | Professional | None | $16.98 | $28.84 | $72.44 |
Health New England Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.99 | Professional | None | $23.44 | $23.44 | $23.99 |
United Setting Professional Modifier None Typical Low $6.31 Median $7.59 Typical High $13.18 | Professional | None | $6.31 | $7.59 | $13.18 |
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 $4.07 Median $4.07 Typical High $5.50 | Professional | 52 · Reduced service | $4.07 | $4.07 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $2.19 | Professional | 53 · Discontinued | $1.62 | $1.62 | $2.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.03 Median $6.03 Typical High $8.32 | Professional | 54 · Surgery only | $6.03 | $6.03 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.66 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $1.10 |
Where Connecticut sits
The same service costs 4.5 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· 26th of 51
$10.72
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.