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 $72.44 Typical High $72.44 | Professional | None | $56.23 | $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 $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | RR · Rental | $5.89 | $5.89 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $77.62 | Facility | None | $72.44 | $72.44 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $112.20 Typical High $186.21 | Professional | None | $48.98 | $112.20 | $186.21 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $104.71 | Professional | None | $42.66 | $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 $28.18 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $7.24 |
Where New Hampshire sits
The same service costs 3.2 times more in Hawaii 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· 34th of 51
$60.26
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.