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 $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $141.25 Typical High $165.96 | Facility | None | $123.03 | $141.25 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
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 $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $186.21 | Professional | None | $50.12 | $114.82 | $186.21 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $48.98 | Facility | None | $29.51 | $29.51 | $48.98 |
United Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $104.71 | Professional | None | $43.65 | $66.07 | $104.71 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
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 $28.84 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $11.48 | $14.79 | $14.79 |
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 $5.75 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $7.41 | $7.41 |
Where New Hampshire sits
The same service costs 2.4 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· 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.