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 $29.51 Median $29.51 Typical High $47.86 | Professional | None | $29.51 | $29.51 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $93.33 | Facility | None | $69.18 | $81.28 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | RR · Rental | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | UE · Used equipment | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $64.57 | Professional | None | $37.15 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $44.67 | Professional | None | $24.55 | $37.15 | $44.67 |
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 $14.79 Median $14.79 Typical High $23.99 | Professional | 52 · Reduced service | $14.79 | $14.79 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $9.55 | Professional | 53 · Discontinued | $5.89 | $5.89 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $7.08 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $4.79 |
Where New Hampshire sits
The same service costs 2.9 times more in Montana than in Nebraska. 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
$44.67
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.