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 $151.36 Median $194.98 Typical High $194.98 | Professional | None | $151.36 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $371.54 Typical High $436.52 | Facility | None | $323.59 | $371.54 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | None | $158.49 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | RR · Rental | $15.85 | $15.85 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $213.80 | Facility | None | $190.55 | $190.55 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $302.00 Typical High $489.78 | Professional | None | $131.83 | $302.00 | $489.78 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
United Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $275.42 | Professional | None | $114.82 | $173.78 | $275.42 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $75.86 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $19.50 |
Where New Hampshire sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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· 30th of 51
$162
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.