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 $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | RR · Rental | $1.91 | $1.91 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | UE · Used equipment | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.14 Median $38.02 Typical High $52.48 | Professional | None | $15.14 | $38.02 | $52.48 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $36.31 | Professional | None | $15.14 | $15.14 | $36.31 |
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 $11.48 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where New Hampshire sits
The same service costs 3.2 times more in Hawaii than in Utah. 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
$19.05
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.