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 $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.09 | Professional | None | $2.24 | $2.24 | $3.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.55 Typical High $4.68 | Professional | None | $2.95 | $3.55 | $4.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.34 Typical High $0.44 | Professional | RR · Rental | $0.28 | $0.34 | $0.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $2.63 Typical High $3.39 | Professional | UE · Used equipment | $2.24 | $2.63 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
ConnectiCare Setting Professional Modifier None Typical Low $4.79 Median $7.94 Typical High $16.98 | Professional | None | $4.79 | $7.94 | $16.98 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.09 Typical High $3.72 | Professional | None | $1.78 | $2.09 | $3.72 |
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 $1.12 Median $1.12 Typical High $1.55 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.62 | Professional | 53 · Discontinued | $0.45 | $0.45 | $0.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.70 Median $1.70 Typical High $2.29 | Professional | 54 · Surgery only | $1.70 | $1.70 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.34 Typical High $0.46 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.30 |
Where Connecticut sits
The same service costs 4.0 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· 22nd of 51
$3.09
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.