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 $33.11 Median $42.66 Typical High $42.66 | Professional | None | $33.11 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $95.50 | Facility | None | $70.79 | $83.18 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | None | $43.65 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $66.07 Typical High $109.65 | Professional | None | $31.62 | $66.07 | $109.65 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $61.66 | Professional | None | $25.12 | $38.02 | $61.66 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $16.60 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $6.61 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.31 | $4.27 | $4.27 |
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· 34th of 51
$42.66
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.