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 $5.01 Median $6.03 Typical High $6.03 | Professional | None | $5.01 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | None | $5.75 | $5.75 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | RR · Rental | $0.58 | $0.58 | $0.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | UE · Used equipment | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.47 Median $10.00 Typical High $16.60 | Professional | None | $4.47 | $10.00 | $16.60 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $9.33 | Professional | None | $3.80 | $5.75 | $9.33 |
Well Sense Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
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 $2.51 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $2.51 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.00 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.76 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.50 | $0.62 | $0.62 |
Where New Hampshire sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 49th of 51
$6.03
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.