How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $7.94 Median $10.47 Typical High $10.47 | Professional | None | $7.94 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.41 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.93 | $1.05 | $1.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Optum Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
1 more rate 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 |
|---|---|---|---|---|---|
Well Sense Setting Facility Modifier HW · State mental health funded + U1 · State-defined + U2 · State-defined + U5 · State-defined + U6 · State-defined + U7 · State-defined Typical Low $616.60 Median $616.60 Typical High $741.31 | Facility | HW · State mental health funded + U1 · State-defined + U2 · State-defined + U5 · State-defined + U6 · State-defined + U7 · State-defined | $616.60 | $616.60 | $741.31 |
Where New Hampshire sits
The same service costs 331.1 times more in New Jersey than in New York. 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· 15th of 51
$10.47
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.