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 $26.92 Median $26.92 Typical High $43.65 | Professional | None | $26.92 | $26.92 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $72.44 | Facility | None | $46.77 | $60.26 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $60.26 Typical High $70.79 | Professional | None | $33.11 | $60.26 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $6.03 Typical High $7.08 | Professional | RR · Rental | $4.57 | $6.03 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $45.71 Typical High $53.70 | Professional | UE · Used equipment | $34.67 | $45.71 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
ConnectiCare Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | None | $81.28 | $81.28 | $107.15 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $33.88 | Professional | None | $18.20 | $27.54 | $33.88 |
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 $13.49 Median $13.49 Typical High $21.88 | Professional | 52 · Reduced service | $13.49 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $8.71 | Professional | 53 · Discontinued | $5.37 | $5.37 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $6.61 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $4.37 |
Where Connecticut sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 26th of 51
$43.65
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.