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 $48.98 Median $63.10 Typical High $63.10 | Professional | None | $48.98 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $141.25 | Facility | None | $102.33 | $120.23 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $158.49 | Professional | None | $51.29 | $97.72 | $158.49 |
United Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $91.20 | Professional | None | $37.15 | $54.95 | $91.20 |
Well Sense Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
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 $24.55 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $24.55 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $9.77 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $6.31 |
Where New Hampshire sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 50th of 51
$61.66
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.