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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $52.48 | Professional | None | $29.51 | $38.90 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.89 Typical High $5.01 | Professional | RR · Rental | $3.31 | $3.89 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $29.51 Typical High $37.15 | Professional | UE · Used equipment | $25.12 | $29.51 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
ConnectiCare Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $151.36 | Professional | None | $52.48 | $89.13 | $151.36 |
United Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $41.69 | Professional | None | $19.50 | $23.44 | $41.69 |
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 $12.59 Median $12.59 Typical High $16.98 | Professional | 52 · Reduced service | $12.59 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | 53 · Discontinued | $5.01 | $5.01 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 54 · Surgery only | $19.05 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.39 |
Where Connecticut sits
The same service costs 3.2 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· 21st of 51
$34.67
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.