How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $15.49 | Professional | None | $14.45 | $14.45 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | RR · Rental | $1.45 | $1.45 | $1.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | UE · Used equipment | $10.96 | $10.96 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.02 Median $19.95 Typical High $29.51 | Professional | None | $12.02 | $19.95 | $29.51 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $18.62 | Professional | None | $8.71 | $12.02 | $18.62 |
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 $2.19 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
Where New Hampshire sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 19th of 51
$14.45
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.