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 $35.48 Median $35.48 Typical High $56.23 | Professional | None | $35.48 | $35.48 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $95.50 | Facility | None | $61.66 | $79.43 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $97.72 | Professional | None | $40.74 | $83.18 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $8.32 Typical High $9.77 | Professional | RR · Rental | $6.31 | $8.32 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $63.10 Typical High $74.13 | Professional | UE · Used equipment | $47.86 | $63.10 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
ConnectiCare Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | None | $104.71 | $104.71 | $138.04 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $44.67 | Professional | None | $25.12 | $38.02 | $44.67 |
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 $17.78 Median $17.78 Typical High $28.18 | Professional | 52 · Reduced service | $17.78 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $11.22 | Professional | 53 · Discontinued | $7.08 | $7.08 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $8.51 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.62 |
Where Connecticut sits
The same service costs 2.6 times more in Montana than in Indiana. 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· 27th of 51
$56.23
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.