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 $10.47 Median $10.47 Typical High $16.98 | Professional | None | $10.47 | $10.47 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $28.84 Typical High $33.88 | Facility | None | $24.55 | $28.84 | $33.88 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | UE · Used equipment | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $13.18 Median $23.44 Typical High $23.44 | Professional | None | $13.18 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $8.91 Median $13.18 Typical High $15.85 | Professional | None | $8.91 | $13.18 | $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 $5.25 Median $5.25 Typical High $8.51 | Professional | 52 · Reduced service | $5.25 | $5.25 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $3.39 | Professional | 53 · Discontinued | $2.14 | $2.14 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.51 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.70 |
Where New Hampshire sits
The same service costs 3.2 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· 26th of 51
$15.85
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.