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 $12.02 Median $12.02 Typical High $14.79 | Professional | None | $12.02 | $12.02 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $26.92 Typical High $32.36 | Facility | None | $20.89 | $26.92 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $25.70 | Professional | None | $16.60 | $21.88 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $2.19 Typical High $2.57 | Professional | RR · Rental | $1.66 | $2.19 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $16.60 Typical High $19.50 | Professional | UE · Used equipment | $12.59 | $16.60 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
ConnectiCare Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $29.51 | Professional | None | $22.39 | $22.39 | $29.51 |
United Setting Professional Modifier None Typical Low $6.31 Median $12.02 Typical High $15.14 | Professional | None | $6.31 | $12.02 | $15.14 |
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 $6.03 Median $6.03 Typical High $7.08 | Professional | 52 · Reduced service | $6.03 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | 53 · Discontinued | $2.40 | $2.40 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.14 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.41 |
Where Connecticut sits
The same service costs 3.2 times more in Montana than in New York. 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· 20th of 51
$16.60
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.