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 $30.90 Median $39.81 Typical High $39.81 | Professional | None | $30.90 | $39.81 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $89.13 | Facility | None | $66.07 | $77.62 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | None | $36.31 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | RR · Rental | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | UE · Used equipment | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Facility | None | $48.98 | $48.98 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $27.54 Median $61.66 Typical High $102.33 | Professional | None | $27.54 | $61.66 | $102.33 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $23.44 Median $35.48 Typical High $57.54 | Professional | None | $23.44 | $35.48 | $57.54 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
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 $15.49 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.17 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.68 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.09 | $3.98 | $3.98 |
Where New Hampshire sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 35th of 51
$37.15
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.