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 $42.66 Median $42.66 Typical High $69.18 | Professional | None | $42.66 | $42.66 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $117.49 Typical High $138.04 | Facility | None | $100.00 | $117.49 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | RR · Rental | $13.18 | $13.18 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | UE · Used equipment | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $95.50 | Professional | None | $53.70 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $64.57 | Professional | None | $36.31 | $53.70 | $64.57 |
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 $21.38 Median $21.38 Typical High $34.67 | Professional | 52 · Reduced service | $21.38 | $21.38 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $13.80 | Professional | 53 · Discontinued | $8.71 | $8.71 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $10.23 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $6.92 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Missouri. 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· 33rd of 51
$64.57
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.