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 $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $8.51 | Professional | None | $6.17 | $6.17 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $12.88 | Professional | None | $7.41 | $9.77 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.81 Median $0.95 Typical High $1.23 | Professional | RR · Rental | $0.81 | $0.95 | $1.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.17 Median $7.24 Typical High $9.33 | Professional | UE · Used equipment | $6.17 | $7.24 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
ConnectiCare Setting Professional Modifier None Typical Low $13.18 Median $21.88 Typical High $34.67 | Professional | None | $13.18 | $21.88 | $34.67 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $10.23 | Professional | None | $4.79 | $5.75 | $10.23 |
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 $3.09 Median $3.09 Typical High $4.27 | Professional | 52 · Reduced service | $3.09 | $3.09 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.70 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | 54 · Surgery only | $4.68 | $4.68 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $0.93 Typical High $1.26 | Professional | 55 · Aftercare only | $0.93 | $0.93 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.83 |
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· 24th of 51
$8.32
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.