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 $26.30 Median $26.30 Typical High $42.66 | Professional | None | $26.30 | $26.30 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $83.18 | Facility | None | $61.66 | $72.44 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | RR · Rental | $8.32 | $8.32 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $33.11 Median $57.54 Typical High $57.54 | Professional | None | $33.11 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $39.81 | Professional | None | $21.88 | $33.11 | $39.81 |
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 $13.18 Median $13.18 Typical High $20.89 | Professional | 52 · Reduced service | $13.18 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $8.51 | Professional | 53 · Discontinued | $5.25 | $5.25 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $6.31 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $4.27 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $4.27 |
Where New Hampshire sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 37th of 51
$39.81
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.