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 $4.90 Median $4.90 Typical High $8.32 | Professional | None | $4.90 | $4.90 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $13.49 Typical High $15.49 | Facility | None | $11.48 | $13.49 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | RR · Rental | $1.70 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | UE · Used equipment | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.17 Median $10.72 Typical High $10.72 | Professional | None | $6.17 | $10.72 | $10.72 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $7.41 | Professional | None | $4.07 | $6.17 | $7.41 |
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 $2.45 Median $2.45 Typical High $4.07 | Professional | 52 · Reduced service | $2.45 | $2.45 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.66 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $0.74 Typical High $1.23 | Professional | 55 · Aftercare only | $0.74 | $0.74 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.81 |
Where New Hampshire sits
The same service costs 2.7 times more in Montana 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· 38th of 51
$7.41
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.