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 $6.46 Median $7.24 Typical High $7.24 | Professional | None | $6.46 | $7.24 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | RR · Rental | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $10.00 | Facility | None | $9.33 | $9.33 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.03 Median $32.36 Typical High $53.70 | Professional | None | $6.03 | $32.36 | $53.70 |
United Setting Professional Modifier None Typical Low $4.27 Median $6.31 Typical High $11.75 | Professional | None | $4.27 | $6.31 | $11.75 |
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 $3.24 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.24 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.29 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.95 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.65 | $0.72 | $0.72 |
Where New Hampshire sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 4th of 51
$32.36
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.