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 $33.88 Median $43.65 Typical High $43.65 | Professional | None | $33.88 | $43.65 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $97.72 | Facility | None | $70.79 | $83.18 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | None | $40.74 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $40.74 | Facility | None | $36.31 | $36.31 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $109.65 | Professional | None | $30.90 | $67.61 | $109.65 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $61.66 | Professional | None | $25.70 | $38.02 | $61.66 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
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 $16.98 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $6.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.39 | $4.37 | $4.37 |
Where New Hampshire sits
The same service costs 2.9 times more in Hawaii 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· 30th of 51
$41.69
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.