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 $38.02 Median $48.98 Typical High $48.98 | Professional | None | $38.02 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $112.20 | Facility | None | $81.28 | $95.50 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $125.89 | Professional | None | $39.81 | $77.62 | $125.89 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $70.79 | Professional | None | $33.11 | $43.65 | $70.79 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $19.05 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $19.05 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.80 | $4.90 | $4.90 |
Where New Hampshire sits
The same service costs 3.4 times more in Hawaii 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· 41st of 51
$52.48
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.