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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $19.95 | Professional | None | $13.80 | $13.80 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $21.38 Typical High $28.84 | Professional | None | $16.22 | $21.38 | $28.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $2.14 Typical High $2.75 | Professional | RR · Rental | $1.82 | $2.14 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $15.85 Typical High $20.42 | Professional | UE · Used equipment | $13.49 | $15.85 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
ConnectiCare Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $91.20 | Professional | None | $25.12 | $48.98 | $91.20 |
Health New England Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $10.72 Median $12.88 Typical High $22.39 | Professional | None | $10.72 | $12.88 | $22.39 |
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 $6.92 Median $6.92 Typical High $9.33 | Professional | 52 · Reduced service | $6.92 | $6.92 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.72 | Professional | 53 · Discontinued | $2.75 | $2.75 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $10.23 Typical High $14.13 | Professional | 54 · Surgery only | $10.23 | $10.23 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.82 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.86 |
Where Connecticut sits
The same service costs 3.5 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· 24th of 51
$18.20
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.