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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | None | $12.59 | $12.59 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $25.12 | Professional | None | $16.60 | $19.50 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.62 Median $1.95 Typical High $2.45 | Professional | RR · Rental | $1.62 | $1.95 | $2.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.30 Median $14.45 Typical High $18.62 | Professional | UE · Used equipment | $12.30 | $14.45 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
ConnectiCare Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $67.61 | Professional | None | $22.39 | $43.65 | $67.61 |
United Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $20.42 | Professional | None | $9.77 | $11.75 | $20.42 |
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 $6.17 Median $6.17 Typical High $8.51 | Professional | 52 · Reduced service | $6.17 | $6.17 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $3.39 | Professional | 53 · Discontinued | $2.51 | $2.51 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $9.33 Typical High $12.59 | Professional | 54 · Surgery only | $9.33 | $9.33 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $1.70 |
Where Connecticut sits
The same service costs 2.9 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· 25th of 51
$16.60
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.