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 $51.29 Median $66.07 Typical High $69.18 | Professional | None | $51.29 | $66.07 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $147.91 | Facility | None | $109.65 | $125.89 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | None | $61.66 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | RR · Rental | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $165.96 | Professional | None | $45.71 | $102.33 | $165.96 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $93.33 | Professional | None | $38.90 | $58.88 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
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 $25.70 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.23 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $6.61 |
Where New Hampshire sits
The same service costs 4.1 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· 30th of 51
$63.10
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.