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 $177.83 Median $239.88 Typical High $239.88 | Professional | None | $177.83 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $331.13 | Facility | None | $245.47 | $288.40 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | RR · Rental | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | UE · Used equipment | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $371.54 | Professional | None | $144.54 | $229.09 | $371.54 |
United Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | None | $134.90 | $204.17 | $331.13 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
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 $89.13 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $23.99 |
Where New Hampshire sits
The same service costs 2.6 times more in Hawaii 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· 16th of 51
$240
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.