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 Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.38 | Professional | None | $1.20 | $1.20 | $1.38 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | AU · Urologic/ostomy supply | $1.95 | $1.95 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.91 | Professional | None | $0.89 | $0.89 | $0.91 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | AU · Urologic/ostomy supply | $4.47 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | UE · Used equipment | $0.68 | $0.68 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.86 Median $3.24 Typical High $4.90 | Professional | None | $1.86 | $3.24 | $4.90 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $3.09 | Professional | None | $1.45 | $1.86 | $3.09 |
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 $0.98 Median $0.98 Typical High $0.98 | Professional | 52 · Reduced service | $0.98 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Where New Hampshire sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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.
New Hampshire· 51st of 51
$1.20
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.