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 $83.18 Median $107.15 Typical High $107.15 | Professional | None | $83.18 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $239.88 | Facility | None | $177.83 | $208.93 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | UE · Used equipment | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Facility | None | $125.89 | $125.89 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $275.42 | Professional | None | $83.18 | $165.96 | $275.42 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $154.88 | Professional | None | $69.18 | $95.50 | $154.88 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
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 $41.69 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $10.72 |
Where New Hampshire sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 35th of 51
$112
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.