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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $13.18 | Professional | None | $9.55 | $9.55 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $19.50 | Professional | None | $12.59 | $14.79 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.26 Median $1.48 Typical High $1.91 | Professional | RR · Rental | $1.26 | $1.48 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $11.22 Typical High $14.45 | Professional | UE · Used equipment | $9.55 | $11.22 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
ConnectiCare Setting Professional Modifier None Typical Low $20.42 Median $33.88 Typical High $37.15 | Professional | None | $20.42 | $33.88 | $37.15 |
Health New England Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $15.85 | Professional | None | $7.59 | $8.91 | $15.85 |
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 $4.79 Median $4.79 Typical High $6.46 | Professional | 52 · Reduced service | $4.79 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.51 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $7.24 Typical High $9.77 | Professional | 54 · Surgery only | $7.24 | $7.24 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.91 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $1.26 |
Where Connecticut sits
The same service costs 2.7 times more in Idaho 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
$13.18
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.