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 $26.30 Median $33.88 Typical High $33.88 | Professional | None | $26.30 | $33.88 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $75.86 | Facility | None | $54.95 | $64.57 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | None | $33.11 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | RR · Rental | $3.31 | $3.31 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Facility | None | $33.88 | $33.88 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $52.48 Typical High $85.11 | Professional | None | $24.55 | $52.48 | $85.11 |
United Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $47.86 | Professional | None | $20.42 | $30.20 | $47.86 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
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 $13.18 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $13.18 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $5.25 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $3.89 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.63 | $3.39 | $3.39 |
Where New Hampshire sits
The same service costs 2.8 times more in Montana than in Kansas. 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· 32nd of 51
$33.88
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.