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 $83.18 Median $107.15 Typical High $107.15 | Professional | None | $83.18 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $239.88 | Facility | None | $173.78 | $204.17 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | RR · Rental | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | UE · Used equipment | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $120.23 | Facility | None | $107.15 | $107.15 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $269.15 | Professional | None | $77.62 | $165.96 | $269.15 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $151.36 | Professional | None | $63.10 | $93.33 | $151.36 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
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 $40.74 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $10.72 |
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· 37th of 51
$100
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.