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 $34.67 Median $34.67 Typical High $47.86 | Professional | None | $34.67 | $34.67 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $93.33 | Facility | None | $60.26 | $77.62 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $91.20 | Professional | None | $58.88 | $77.62 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $7.76 Typical High $9.12 | Professional | RR · Rental | $5.89 | $7.76 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $57.54 Typical High $67.61 | Professional | UE · Used equipment | $43.65 | $57.54 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
ConnectiCare Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | None | $85.11 | $85.11 | $112.20 |
United Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $43.65 | Professional | None | $23.99 | $34.67 | $43.65 |
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 $17.38 Median $17.38 Typical High $23.99 | Professional | 52 · Reduced service | $17.38 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 53 · Discontinued | $6.92 | $6.92 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $7.24 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $4.79 |
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
$58.88
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.