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 $3.47 Median $4.17 Typical High $4.17 | Professional | None | $3.47 | $4.17 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $4.27 Typical High $4.27 | Professional | None | $3.98 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | RR · Rental | $0.40 | $0.40 | $0.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | UE · Used equipment | $3.02 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.09 Median $7.08 Typical High $11.48 | Professional | None | $3.09 | $7.08 | $11.48 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $6.46 | Professional | None | $2.63 | $3.98 | $6.46 |
Well Sense Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
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 $0.52 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.52 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.35 | $0.42 | $0.42 |
Where New Hampshire sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 42nd of 51
$4.17
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.