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 $28.84 Median $28.84 Typical High $46.77 | Professional | None | $28.84 | $28.84 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $79.43 Typical High $93.33 | Facility | None | $67.61 | $79.43 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $64.57 Typical High $64.57 | Professional | None | $36.31 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $43.65 | Professional | None | $33.11 | $36.31 | $43.65 |
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 $14.45 Median $14.45 Typical High $23.44 | Professional | 52 · Reduced service | $14.45 | $14.45 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $9.33 | Professional | 53 · Discontinued | $5.75 | $5.75 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $4.68 |
Where New Hampshire sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 40th of 51
$43.65
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.