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 $10.96 Median $14.13 Typical High $14.13 | Professional | None | $10.96 | $14.13 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $26.92 Typical High $31.62 | Facility | None | $22.91 | $26.92 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | None | $17.78 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | UE · Used equipment | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $18.20 | Facility | None | $16.22 | $16.22 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.75 Median $21.88 Typical High $35.48 | Professional | None | $11.75 | $21.88 | $35.48 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $20.42 | Professional | None | $8.32 | $12.59 | $20.42 |
Well Sense Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
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 $5.50 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $5.50 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.19 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $1.66 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.10 | $1.41 | $1.41 |
Where New Hampshire sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 22nd of 51
$17.78
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.