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 $24.55 Median $30.90 Typical High $57.54 | Professional | None | $24.55 | $30.90 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $67.61 | Facility | None | $50.12 | $58.88 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | RR · Rental | $3.09 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | UE · Used equipment | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $47.86 Typical High $77.62 | Professional | None | $24.55 | $47.86 | $77.62 |
United Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $44.67 | Professional | None | $19.50 | $26.92 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
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 $12.30 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $12.30 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $4.90 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $3.72 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.45 | $3.09 | $3.09 |
Where New Hampshire sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 43rd of 51
$30.90
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.