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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.25 | Professional | None | $3.89 | $3.89 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $6.03 Typical High $7.76 | Professional | None | $5.13 | $6.03 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.51 Median $0.60 Typical High $0.78 | Professional | RR · Rental | $0.51 | $0.60 | $0.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.80 Median $4.47 Typical High $5.75 | Professional | UE · Used equipment | $3.80 | $4.47 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
ConnectiCare Setting Professional Modifier None Typical Low $8.13 Median $13.49 Typical High $15.85 | Professional | None | $8.13 | $13.49 | $15.85 |
United Setting Professional Modifier None Typical Low $3.02 Median $3.63 Typical High $6.31 | Professional | None | $3.02 | $3.63 | $6.31 |
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 $1.95 Median $1.95 Typical High $2.57 | Professional | 52 · Reduced service | $1.95 | $1.95 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $1.00 | Professional | 53 · Discontinued | $0.78 | $0.78 | $1.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.88 Median $2.88 Typical High $3.89 | Professional | 54 · Surgery only | $2.88 | $2.88 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.58 Median $0.58 Typical High $0.76 | Professional | 55 · Aftercare only | $0.58 | $0.58 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.50 |
Where Connecticut sits
The same service costs 2.7 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
$5.25
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.