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 $38.90 Median $50.12 Typical High $50.12 | Professional | None | $38.90 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $112.20 | Facility | None | $83.18 | $97.72 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | UE · Used equipment | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None | $37.15 | $37.15 | $51.29 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $37.15 Median $79.43 Typical High $128.82 | Professional | None | $37.15 | $79.43 | $128.82 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $72.44 | Professional | None | $30.90 | $44.67 | $72.44 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
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 $19.50 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $19.50 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.89 | $5.01 | $5.01 |
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· 42nd of 51
$47.86
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.