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 $1.26 Median $1.51 Typical High $1.51 | Professional | None | $1.26 | $1.51 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | RR · Rental | $0.18 | $0.18 | $0.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | UE · Used equipment | $1.38 | $1.38 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.23 Median $2.51 Typical High $4.17 | Professional | None | $1.23 | $2.51 | $4.17 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.45 Typical High $2.34 | Professional | None | $0.95 | $1.45 | $2.34 |
Well Sense Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
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 $0.63 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.63 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.25 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.19 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.13 | $0.15 | $0.15 |
Where New Hampshire sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 28th of 51
$1.82
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.