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 $17.78 Median $17.78 Typical High $28.18 | Professional | None | $17.78 | $17.78 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $56.23 | Facility | None | $40.74 | $47.86 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | RR · Rental | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $38.90 | Professional | None | $21.88 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $26.92 | Professional | None | $16.98 | $21.88 | $26.92 |
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 $8.91 Median $8.91 Typical High $14.13 | Professional | 52 · Reduced service | $8.91 | $8.91 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $5.62 | Professional | 53 · Discontinued | $3.55 | $3.55 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $4.27 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $2.82 |
Where New Hampshire sits
The same service costs 5.9 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· 25th of 51
$26.92
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.