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 $7.76 Median $7.76 Typical High $12.59 | Professional | None | $7.76 | $7.76 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $21.38 Typical High $25.12 | Facility | None | $18.20 | $21.38 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | RR · Rental | $2.69 | $2.69 | $2.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | UE · Used equipment | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $9.77 Median $17.38 Typical High $17.38 | Professional | None | $9.77 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $15.85 | Professional | None | $8.91 | $9.77 | $15.85 |
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 $3.89 Median $3.89 Typical High $6.31 | Professional | 52 · Reduced service | $3.89 | $3.89 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $2.51 | Professional | 53 · Discontinued | $1.58 | $1.58 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.86 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $1.26 |
Where New Hampshire sits
The same service costs 3.0 times more in Montana 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
$11.75
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.