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 $56.23 | Professional | None | $34.67 | $34.67 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $109.65 | Facility | None | $81.28 | $95.50 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | RR · Rental | $10.47 | $10.47 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | UE · Used equipment | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $75.86 | Professional | None | $43.65 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $52.48 | Professional | None | $28.84 | $43.65 | $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 $11.22 | Professional | 53 · Discontinued | $6.92 | $6.92 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $8.32 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $5.62 |
Where New Hampshire sits
The same service costs 2.7 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· 35th 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.