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 $17.78 Median $22.91 Typical High $22.91 | Professional | None | $17.78 | $22.91 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $43.65 Typical High $51.29 | Facility | None | $37.15 | $43.65 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | UE · Used equipment | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Facility | None | $22.91 | $22.91 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.60 Median $35.48 Typical High $57.54 | Professional | None | $16.60 | $35.48 | $57.54 |
United Setting Professional Modifier None Typical Low $13.80 Median $19.95 Typical High $32.36 | Professional | None | $13.80 | $19.95 | $32.36 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
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 $8.91 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $8.91 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $3.55 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $2.63 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.78 | $2.29 | $2.29 |
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· 50th of 51
$17.38
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.