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 $0.93 Median $0.93 Typical High $0.93 | Professional | None | $0.93 | $0.93 | $0.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | UE · Used equipment | $0.59 | $0.59 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.79 Median $1.51 Typical High $2.14 | Professional | None | $0.79 | $1.51 | $2.14 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.87 Typical High $1.45 | Professional | None | $0.68 | $0.87 | $1.45 |
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 $0.47 Median $0.47 Typical High $0.47 | Professional | 52 · Reduced service | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 53 · Discontinued | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where New Hampshire sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 48th of 51
$0.87
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.