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 $51.29 Median $51.29 Typical High $81.28 | Professional | None | $51.29 | $51.29 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $162.18 | Facility | None | $120.23 | $141.25 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | RR · Rental | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $112.20 | Professional | None | $64.57 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $77.62 | Professional | None | $42.66 | $64.57 | $77.62 |
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 $25.70 Median $25.70 Typical High $40.74 | Professional | 52 · Reduced service | $25.70 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $16.22 | Professional | 53 · Discontinued | $10.23 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $12.30 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $8.13 |
Where New Hampshire sits
The same service costs 2.9 times more in Hawaii than in New York. 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
$77.62
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.