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 $3.89 Median $4.68 Typical High $4.68 | Professional | None | $3.89 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | RR · Rental | $0.34 | $0.34 | $0.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.75 | Facility | None | $5.37 | $5.37 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.80 Median $7.76 Typical High $12.88 | Professional | None | $3.80 | $7.76 | $12.88 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.47 Typical High $7.24 | Professional | None | $3.02 | $4.47 | $7.24 |
Well Sense Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
2 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 $0.59 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.59 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.39 | $0.47 | $0.47 |
Where New Hampshire sits
The same service costs 4.2 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· 47th of 51
$4.47
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.