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 $19.50 Median $25.12 Typical High $25.12 | Professional | None | $19.50 | $25.12 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $48.98 Typical High $56.23 | Facility | None | $41.69 | $48.98 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $40.74 | Professional | None | $32.36 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | RR · Rental | $3.24 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | UE · Used equipment | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $38.90 | Facility | None | $30.20 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.89 Median $38.90 Typical High $64.57 | Professional | None | $20.89 | $38.90 | $64.57 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.39 Typical High $36.31 | Professional | None | $16.98 | $22.39 | $36.31 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
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 $9.77 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $9.77 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $3.89 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $2.95 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.95 | $2.51 | $2.51 |
Where New Hampshire sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 25th of 51
$32.36
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.