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 $40.74 Median $52.48 Typical High $52.48 | Professional | None | $40.74 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $117.49 | Facility | None | $85.11 | $100.00 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | None | $54.95 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $69.18 | Facility | None | $63.10 | $63.10 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $131.83 | Professional | None | $41.69 | $81.28 | $131.83 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
United Setting Professional Modifier None Typical Low $34.67 Median $45.71 Typical High $74.13 | Professional | None | $34.67 | $45.71 | $74.13 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $19.95 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.03 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $5.25 | $5.25 |
Where New Hampshire sits
The same service costs 4.3 times more in Hawaii 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· 36th of 51
$54.95
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.