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 $11.48 Median $14.79 Typical High $14.79 | Professional | None | $11.48 | $14.79 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $28.84 Typical High $33.11 | Facility | None | $24.55 | $28.84 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | RR · Rental | $1.15 | $1.15 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | UE · Used equipment | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.45 | Facility | None | $13.49 | $13.49 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $22.91 Typical High $37.15 | Professional | None | $10.00 | $22.91 | $37.15 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.18 Typical High $20.89 | Professional | None | $8.71 | $13.18 | $20.89 |
Well Sense Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
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 $5.75 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.29 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.24 Typical High $2.24 | Professional | 55 · Aftercare only | $1.74 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.48 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.15 | $1.48 | $1.48 |
Where New Hampshire sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 38th of 51
$11.48
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.