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 $2.69 Median $3.47 Typical High $3.47 | Professional | None | $2.69 | $3.47 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $6.61 Typical High $7.76 | Facility | None | $5.62 | $6.61 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $3.55 | Professional | None | $3.39 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | RR · Rental | $0.34 | $0.34 | $0.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.82 Median $5.37 Typical High $8.71 | Professional | None | $2.82 | $5.37 | $8.71 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.02 Typical High $5.01 | Professional | None | $2.04 | $3.02 | $5.01 |
Well Sense Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
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 $1.35 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.35 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.69 Typical High $0.69 | Professional | 53 · Discontinued | $0.54 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.40 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.27 | $0.35 | $0.35 |
Where New Hampshire sits
The same service costs 4.9 times more in Kansas 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· 36th of 51
$3.47
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.