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 $17.78 Median $17.78 Typical High $30.90 | Professional | None | $17.78 | $17.78 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $48.98 Typical High $57.54 | Facility | None | $41.69 | $48.98 | $57.54 |
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 Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $39.81 | Professional | None | $22.39 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $26.92 | Professional | None | $15.14 | $22.39 | $26.92 |
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 $8.91 Median $8.91 Typical High $15.49 | Professional | 52 · Reduced service | $8.91 | $8.91 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $6.17 | Professional | 53 · Discontinued | $3.63 | $3.63 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $4.68 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $3.09 |
Where New Hampshire sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 41st of 51
$26.92
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.