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 $33.88 Median $33.88 Typical High $54.95 | Professional | None | $33.88 | $33.88 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $107.15 | Facility | None | $79.43 | $93.33 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | UE · Used equipment | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $74.13 | Professional | None | $42.66 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $51.29 | Professional | None | $28.18 | $42.66 | $51.29 |
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 $16.98 Median $16.98 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $10.96 | Professional | 53 · Discontinued | $6.76 | $6.76 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $8.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $5.50 |
Where New Hampshire sits
The same service costs 2.8 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· 34th of 51
$51.29
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.