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 $5.62 Median $5.62 Typical High $8.71 | Professional | None | $5.62 | $5.62 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $12.59 Typical High $15.14 | Facility | None | $9.77 | $12.59 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $13.49 Typical High $16.22 | Professional | None | $10.47 | $13.49 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.02 Median $1.35 Typical High $1.58 | Professional | RR · Rental | $1.02 | $1.35 | $1.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.76 Median $10.23 Typical High $12.02 | Professional | UE · Used equipment | $7.76 | $10.23 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
ConnectiCare Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | None | $17.78 | $17.78 | $23.44 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $7.41 | Professional | None | $4.07 | $6.17 | $7.41 |
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 $2.82 Median $2.82 Typical High $4.47 | Professional | 52 · Reduced service | $2.82 | $2.82 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.78 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $1.32 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.89 |
Where Connecticut sits
The same service costs 2.7 times more in Montana 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· 21st of 51
$10.47
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.