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 $20.89 Median $26.92 Typical High $26.92 | Professional | None | $20.89 | $26.92 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $60.26 | Facility | None | $44.67 | $52.48 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | None | $25.70 | $25.70 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | RR · Rental | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | UE · Used equipment | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Facility | None | $33.88 | $33.88 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $19.95 Median $41.69 Typical High $69.18 | Professional | None | $19.95 | $41.69 | $69.18 |
United Setting Professional Modifier None Typical Low $16.60 Median $23.99 Typical High $38.90 | Professional | None | $16.60 | $23.99 | $38.90 |
Well Sense Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
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 $10.47 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $10.47 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $4.17 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.16 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.09 | $2.69 | $2.69 |
Where New Hampshire sits
The same service costs 3.1 times more in Montana 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· 33rd of 51
$25.70
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.