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 $56.23 Median $64.57 Typical High $64.57 | Professional | None | $56.23 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $147.91 | Facility | None | $107.15 | $125.89 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | RR · Rental | $7.08 | $7.08 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Facility | None | $75.86 | $75.86 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $165.96 | Professional | None | $52.48 | $102.33 | $165.96 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $93.33 | Professional | None | $43.65 | $57.54 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
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 $28.18 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $11.22 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.32 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.62 | $6.46 | $6.46 |
Where New Hampshire sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 39th of 51
$70.79
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.