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 $5.37 Median $6.46 Typical High $6.46 | Professional | None | $5.37 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Professional | None | $6.17 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | RR · Rental | $0.62 | $0.62 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | UE · Used equipment | $4.57 | $4.57 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Facility | None | $7.41 | $7.41 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.79 Median $10.72 Typical High $17.38 | Professional | None | $4.79 | $10.72 | $17.38 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $10.00 | Professional | None | $4.07 | $6.17 | $10.00 |
Well Sense Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
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 $0.79 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.79 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.54 | $0.65 | $0.65 |
Where New Hampshire sits
The same service costs 2.0 times more in Montana than in Florida. 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
$6.46
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.