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 $21.38 Median $27.54 Typical High $27.54 | Professional | None | $21.38 | $27.54 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $53.70 Typical High $63.10 | Facility | None | $45.71 | $53.70 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | RR · Rental | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
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 $20.42 Median $43.65 Typical High $70.79 | Professional | None | $20.42 | $43.65 | $70.79 |
United Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $39.81 | Professional | None | $16.98 | $24.55 | $39.81 |
Well Sense Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
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 $10.72 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $10.72 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $4.27 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $3.24 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.14 | $2.75 | $2.75 |
Where New Hampshire sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 31st of 51
$27.54
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.