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 $57.54 Median $72.44 Typical High $72.44 | Professional | None | $57.54 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $162.18 | Facility | None | $120.23 | $141.25 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | None | $77.62 | $77.62 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | RR · Rental | $7.76 | $7.76 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | UE · Used equipment | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Facility | None | $81.28 | $81.28 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $186.21 | Professional | None | $57.54 | $112.20 | $186.21 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $104.71 | Professional | None | $47.86 | $64.57 | $104.71 |
Well Sense Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
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 $28.84 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.71 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $7.24 |
Where New Hampshire sits
The same service costs 5.1 times more in Kansas than in Florida. 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· 40th of 51
$77.62
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.