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 $74.13 Median $74.13 Typical High $120.23 | Professional | None | $74.13 | $74.13 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $239.88 | Facility | None | $173.78 | $204.17 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | RR · Rental | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | None | $93.33 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $112.20 | Professional | None | $58.88 | $93.33 | $112.20 |
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 $37.15 Median $37.15 Typical High $60.26 | Professional | 52 · Reduced service | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $23.99 | Professional | 53 · Discontinued | $15.14 | $15.14 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $17.78 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $12.02 |
Where New Hampshire sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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· 23rd of 51
$112
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.