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 $44.67 Median $57.54 Typical High $57.54 | Professional | None | $44.67 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $128.82 | Facility | None | $93.33 | $109.65 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | None | $54.95 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $38.90 Median $89.13 Typical High $144.54 | Professional | None | $38.90 | $89.13 | $144.54 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $81.28 | Professional | None | $33.88 | $50.12 | $81.28 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
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 $22.39 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.91 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $6.61 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.47 | $5.75 | $5.75 |
Where New Hampshire sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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
$45.71
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.