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 $32.36 Median $41.69 Typical High $41.69 | Professional | None | $32.36 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $79.43 Typical High $93.33 | Facility | None | $67.61 | $79.43 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $44.67 | Facility | None | $41.69 | $41.69 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $104.71 | Professional | None | $30.20 | $64.57 | $104.71 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $58.88 | Professional | None | $24.55 | $36.31 | $58.88 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
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 $15.85 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $4.79 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
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· 35th of 51
$40.74
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.