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 $316.23 Median $407.38 Typical High $407.38 | Professional | None | $316.23 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $776.25 Typical High $912.01 | Facility | None | $676.08 | $776.25 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | None | $371.54 | $371.54 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | RR · Rental | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | UE · Used equipment | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $1,023.29 | Professional | None | $288.40 | $630.96 | $1,023.29 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
United Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $575.44 | Professional | None | $239.88 | $363.08 | $575.44 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
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 $158.49 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $40.74 |
Where New Hampshire sits
The same service costs 3.0 times more in Montana than in Florida. 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· 37th of 51
$372
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.