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 $5.25 Median $6.31 Typical High $6.31 | Professional | None | $5.25 | $6.31 | $6.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | None | $6.03 | $6.31 | $6.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | RR · Rental | $0.60 | $0.60 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | UE · Used equipment | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.68 Median $10.47 Typical High $16.98 | Professional | None | $4.68 | $10.47 | $16.98 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.89 Typical High $9.77 | Professional | None | $3.98 | $5.89 | $9.77 |
Well Sense Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
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 $2.57 Median $3.16 Typical High $3.16 | Professional | 52 · Reduced service | $2.57 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $1.05 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.78 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.63 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.52 | $0.63 | $0.63 |
Where New Hampshire sits
The same service costs 2.1 times more in Hawaii 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· 41st of 51
$6.31
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.