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 $40.74 Median $52.48 Typical High $52.48 | Professional | None | $40.74 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $102.33 Typical High $117.49 | Facility | None | $87.10 | $102.33 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | None | $42.66 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Facility | None | $46.77 | $46.77 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $81.28 Typical High $134.90 | Professional | None | $36.31 | $81.28 | $134.90 |
United Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | None | $19.05 | $19.05 | $36.31 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $75.86 | Professional | None | $30.90 | $46.77 | $75.86 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $20.42 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.17 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $5.25 | $5.25 |
Where New Hampshire sits
The same service costs 2.9 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
$43.65
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.