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 $27.54 Median $27.54 Typical High $44.67 | Professional | None | $27.54 | $27.54 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $87.10 | Facility | None | $64.57 | $75.86 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | UE · Used equipment | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $60.26 | Professional | None | $34.67 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $41.69 | Professional | None | $22.91 | $34.67 | $41.69 |
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 $13.80 Median $13.80 Typical High $21.88 | Professional | 52 · Reduced service | $13.80 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $8.91 | Professional | 53 · Discontinued | $5.50 | $5.50 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $6.61 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.47 |
Where New Hampshire sits
The same service costs 2.8 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· 39th of 51
$41.69
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.