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 $34.67 Median $34.67 Typical High $54.95 | Professional | None | $34.67 | $34.67 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $109.65 | Facility | None | $79.43 | $93.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | RR · Rental | $11.75 | $11.75 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | UE · Used equipment | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $75.86 | Professional | None | $42.66 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $52.48 | Professional | None | $28.84 | $42.66 | $52.48 |
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 $17.38 Median $17.38 Typical High $27.54 | Professional | 52 · Reduced service | $17.38 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $10.96 | Professional | 53 · Discontinued | $6.92 | $6.92 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $8.32 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $5.50 |
Where New Hampshire sits
The same service costs 2.4 times more in Hawaii 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
$52.48
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.