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 $38.02 Median $50.12 Typical High $50.12 | Professional | None | $38.02 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $109.65 | Facility | None | $79.43 | $93.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | RR · Rental | $5.01 | $5.01 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $123.03 | Professional | None | $40.74 | $75.86 | $123.03 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $70.79 | Professional | None | $33.11 | $42.66 | $70.79 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $18.62 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $18.62 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.59 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.62 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.80 | $5.01 | $5.01 |
Where New Hampshire sits
The same service costs 3.3 times more in Hawaii 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· 39th of 51
$50.12
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.