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 $23.44 Median $23.44 Typical High $37.15 | Professional | None | $23.44 | $23.44 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $74.13 | Facility | None | $54.95 | $64.57 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | RR · Rental | $7.41 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | UE · Used equipment | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $51.29 | Professional | None | $29.51 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $35.48 | Professional | None | $19.50 | $29.51 | $35.48 |
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 $11.75 Median $11.75 Typical High $18.62 | Professional | 52 · Reduced service | $11.75 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $7.41 | Professional | 53 · Discontinued | $4.68 | $4.68 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $5.62 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.72 |
Where New Hampshire sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 38th of 51
$35.48
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.