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 $63.10 Median $81.28 Typical High $81.28 | Professional | None | $63.10 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $158.49 Typical High $181.97 | Facility | None | $134.90 | $158.49 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | RR · Rental | $8.13 | $8.13 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $63.10 Median $125.89 Typical High $208.93 | Professional | None | $63.10 | $125.89 | $208.93 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $117.49 | Professional | None | $52.48 | $72.44 | $117.49 |
Well Sense Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
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 $31.62 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $9.55 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.31 | $8.13 | $8.13 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana 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· 37th of 51
$81.28
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.