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 $16.22 Median $16.22 Typical High $28.18 | Professional | None | $16.22 | $16.22 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $44.67 Typical High $51.29 | Facility | None | $38.02 | $44.67 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.42 Median $35.48 Typical High $35.48 | Professional | None | $20.42 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $24.55 | Professional | None | $13.49 | $20.42 | $24.55 |
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 $8.13 Median $8.13 Typical High $14.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $5.62 | Professional | 53 · Discontinued | $3.24 | $3.24 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $4.17 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.82 |
Where New Hampshire sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 40th of 51
$24.55
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.