How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | RR · Rental | $1.29 | $1.29 | $1.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | UE · Used equipment | $9.55 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $13.18 Median $21.88 Typical High $30.90 | Professional | None | $13.18 | $21.88 | $30.90 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $19.95 | Professional | None | $9.77 | $13.18 | $19.95 |
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 $6.76 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.35 |
Where New Hampshire sits
The same service costs 2.6 times more in Hawaii than in Kentucky. 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· 44th of 51
$13.49
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.