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 $0.46 Median $0.50 Typical High $0.50 | Professional | None | $0.46 | $0.50 | $0.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.30 Typical High $0.30 | Professional | None | $0.28 | $0.30 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.22 Median $0.22 Typical High $0.28 | Professional | UE · Used equipment | $0.22 | $0.22 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.30 Median $0.45 Typical High $0.81 | Professional | None | $0.30 | $0.45 | $0.81 |
United Setting Professional Modifier None Typical Low $0.30 Median $0.45 Typical High $0.81 | Professional | None | $0.30 | $0.45 | $0.81 |
Well Sense Setting Facility Modifier None Typical Low $0.93 Median $0.93 Typical High $1.48 | Facility | None | $0.93 | $0.93 | $1.48 |
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 $0.07 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.07 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where New Hampshire sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 45th of 51
$0.44
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.