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 $38.02 Median $48.98 Typical High $48.98 | Professional | None | $38.02 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $93.33 Typical High $109.65 | Facility | None | $81.28 | $93.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | None | $46.77 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | RR · Rental | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Facility | None | $50.12 | $50.12 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $75.86 Typical High $123.03 | Professional | None | $36.31 | $75.86 | $123.03 |
United Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $69.18 | Professional | None | $28.84 | $43.65 | $69.18 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $19.05 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $19.05 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.59 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.80 | $4.90 | $4.90 |
Where New Hampshire sits
The same service costs 3.0 times more in Hawaii 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· 31st of 51
$47.86
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.