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 $37.15 Median $47.86 Typical High $47.86 | Professional | None | $37.15 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $107.15 | Facility | None | $79.43 | $93.33 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | None | $47.86 | $48.98 | $48.98 |
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 $35.48 Median $35.48 Typical High $35.48 | Professional | UE · Used equipment | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Facility | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $123.03 | Professional | None | $38.90 | $74.13 | $123.03 |
United Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $69.18 | Professional | None | $28.18 | $42.66 | $69.18 |
Well Sense Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
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 $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $18.62 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $7.41 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $5.62 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.72 | $4.79 | $4.79 |
Where New Hampshire sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 48th of 51
$48.98
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.