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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $36.31 | Professional | None | $23.99 | $28.18 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.34 Median $2.82 Typical High $3.63 | Professional | RR · Rental | $2.34 | $2.82 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $20.89 Typical High $26.92 | Professional | UE · Used equipment | $17.78 | $20.89 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
ConnectiCare Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $64.57 | Professional | None | $38.02 | $61.66 | $64.57 |
United Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $29.51 | Professional | None | $14.13 | $16.98 | $29.51 |
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 $8.91 Median $8.91 Typical High $12.02 | Professional | 52 · Reduced service | $8.91 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $13.49 Typical High $18.20 | Professional | 54 · Surgery only | $13.49 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $3.55 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.40 |
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
$24.55
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.