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 $36.31 Median $46.77 Typical High $46.77 | Professional | None | $36.31 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $107.15 | Facility | None | $77.62 | $91.20 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | None | $39.81 | $39.81 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | RR · Rental | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | UE · Used equipment | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $61.66 | Facility | None | $56.23 | $56.23 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $33.11 Median $74.13 Typical High $120.23 | Professional | None | $33.11 | $74.13 | $120.23 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $67.61 | Professional | None | $28.18 | $41.69 | $67.61 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
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 $18.20 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $7.41 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.50 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.63 | $4.68 | $4.68 |
Where New Hampshire sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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
$40.74
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.