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 $25.70 Median $33.11 Typical High $33.11 | Professional | None | $25.70 | $33.11 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $74.13 | Facility | None | $53.70 | $63.10 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | RR · Rental | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | UE · Used equipment | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Facility | None | $33.11 | $33.11 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.99 Median $51.29 Typical High $83.18 | Professional | None | $23.99 | $51.29 | $83.18 |
United Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $46.77 | Professional | None | $19.95 | $28.84 | $46.77 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
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 $12.88 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $5.13 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $3.80 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.51 | $3.31 | $3.31 |
Where New Hampshire sits
The same service costs 2.6 times more in Montana than in Delaware. 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· 36th of 51
$30.90
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.