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 $173.78 Median $223.87 Typical High $223.87 | Professional | None | $173.78 | $223.87 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $302.00 | Facility | None | $223.87 | $257.04 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | None | $199.53 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | RR · Rental | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $338.84 | Professional | None | $131.83 | $208.93 | $338.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $323.59 | Professional | None | $131.83 | $199.53 | $323.59 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $87.10 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $22.39 |
Where New Hampshire sits
The same service costs 2.9 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· 23rd of 51
$204
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.