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 Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $33.88 | Professional | None | $20.42 | $20.42 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $45.71 Typical High $54.95 | Facility | None | $35.48 | $45.71 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $58.88 | Professional | None | $33.11 | $50.12 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.80 Median $5.01 Typical High $5.89 | Professional | RR · Rental | $3.80 | $5.01 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.84 Median $37.15 Typical High $43.65 | Professional | UE · Used equipment | $28.84 | $37.15 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
ConnectiCare Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | None | $67.61 | $67.61 | $89.13 |
United Setting Professional Modifier None Typical Low $10.96 Median $22.39 Typical High $28.18 | Professional | None | $10.96 | $22.39 | $28.18 |
4 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 $10.23 Median $10.23 Typical High $16.98 | Professional | 52 · Reduced service | $10.23 | $10.23 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $6.76 | Professional | 53 · Discontinued | $4.07 | $4.07 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $5.01 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $3.39 |
Where Connecticut sits
The same service costs 3.3 times more in Montana than in Missouri. 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
$36.31
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.