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 $77.62 Median $100.00 Typical High $100.00 | Professional | None | $77.62 | $100.00 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $194.98 Typical High $223.87 | Facility | None | $165.96 | $194.98 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | None | $93.33 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | RR · Rental | $9.33 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | UE · Used equipment | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $257.04 | Professional | None | $69.18 | $154.88 | $257.04 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $144.54 | Professional | None | $58.88 | $89.13 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
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 $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $10.00 |
Where New Hampshire sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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
$97.72
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.