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 $537.03 Median $630.96 Typical High $630.96 | Professional | None | $537.03 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Facility | None | $1,047.13 | $1,230.27 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | RR · Rental | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | UE · Used equipment | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $1,000.00 Typical High $1,621.81 | Professional | None | $467.74 | $1,000.00 | $1,621.81 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Facility | None | $478.63 | $478.63 | $691.83 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $912.01 | Professional | None | $389.05 | $562.34 | $912.01 |
Well Sense Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $269.15 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $63.10 |
Where New Hampshire sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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
$617
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.