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 $25.70 Median $33.11 Typical High $33.11 | Professional | None | $25.70 | $33.11 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $74.13 | Facility | None | $53.70 | $63.10 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | None | $34.67 | $34.67 | $35.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | RR · Rental | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | UE · Used equipment | $26.30 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Facility | None | $38.90 | $38.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $26.30 Median $51.29 Typical High $83.18 | Professional | None | $26.30 | $51.29 | $83.18 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $47.86 | Professional | None | $21.88 | $28.84 | $47.86 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
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 $12.88 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $5.13 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $3.80 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.51 | $3.31 | $3.31 |
Where New Hampshire sits
The same service costs 3.0 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· 40th of 51
$34.67
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.