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 $41.69 Median $53.70 Typical High $53.70 | Professional | None | $41.69 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $120.23 | Facility | None | $89.13 | $104.71 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $138.04 | Professional | None | $39.81 | $83.18 | $138.04 |
United Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $77.62 | Professional | None | $33.11 | $47.86 | $77.62 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $20.89 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $20.89 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $8.32 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $6.31 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.17 | $5.37 | $5.37 |
Where New Hampshire sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 33rd of 51
$53.70
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.