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 $3.89 Median $7.94 Typical High $7.94 | Professional | None | $3.89 | $7.94 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | UE · Used equipment | $1.07 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.85 Median $1.23 Typical High $3.63 | Professional | None | $0.85 | $1.23 | $3.63 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.85 Typical High $8.71 | Professional | None | $0.56 | $0.85 | $8.71 |
3 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 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier KL · Delivered by mail Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | KL · Delivered by mail | $6.92 | $6.92 | $6.92 |
Where New Hampshire sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 19th of 51
$1.41
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.