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 $32.36 Median $41.69 Typical High $41.69 | Professional | None | $32.36 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $93.33 | Facility | None | $69.18 | $81.28 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | RR · Rental | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Facility | None | $43.65 | $43.65 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $33.88 Median $64.57 Typical High $107.15 | Professional | None | $33.88 | $64.57 | $107.15 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $60.26 | Professional | None | $24.55 | $37.15 | $60.26 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
2 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 55 · Aftercare only Typical Low $4.90 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $4.90 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
Where New Hampshire sits
The same service costs 2.2 times more in Montana than in West 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· 35th of 51
$42.66
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.