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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $26.30 | Professional | None | $19.05 | $19.05 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $38.90 | Professional | None | $25.70 | $30.20 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $3.02 Typical High $3.89 | Professional | RR · Rental | $2.51 | $3.02 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $22.39 Typical High $28.84 | Professional | UE · Used equipment | $19.05 | $22.39 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
ConnectiCare Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $75.86 | Professional | None | $40.74 | $67.61 | $75.86 |
United Setting Professional Modifier None Typical Low $15.14 Median $18.20 Typical High $31.62 | Professional | None | $15.14 | $18.20 | $31.62 |
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 $9.55 Median $9.55 Typical High $13.18 | Professional | 52 · Reduced service | $9.55 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $5.25 | Professional | 53 · Discontinued | $3.89 | $3.89 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | 54 · Surgery only | $14.45 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $3.80 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.57 |
Where Connecticut sits
The same service costs 2.8 times more in Hawaii 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
$26.30
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.