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 $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $87.10 | Facility | None | $56.23 | $72.44 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $87.10 | Professional | None | $40.74 | $74.13 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $7.41 Typical High $8.71 | Professional | RR · Rental | $5.62 | $7.41 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $56.23 Typical High $66.07 | Professional | UE · Used equipment | $42.66 | $56.23 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
ConnectiCare Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $100.00 | $131.83 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $40.74 | Professional | None | $22.39 | $33.11 | $40.74 |
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 $16.22 Median $16.22 Typical High $23.44 | Professional | 52 · Reduced service | $16.22 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $9.33 | Professional | 53 · Discontinued | $6.46 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.68 |
Where Connecticut sits
The same service costs 3.0 times more in Montana than in Ohio. 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
$51.29
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.