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 $56.23 Median $75.86 Typical High $75.86 | Professional | None | $56.23 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $162.18 | Facility | None | $117.49 | $138.04 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | None | $56.23 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | RR · Rental | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $112.20 Typical High $181.97 | Professional | None | $48.98 | $112.20 | $181.97 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $102.33 | Professional | None | $42.66 | $63.10 | $102.33 |
Well Sense Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
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 $28.18 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $28.18 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $11.22 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $8.32 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.62 | $7.59 | $7.59 |
Where New Hampshire sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 38th of 51
$57.54
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.