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 $229.09 Median $295.12 Typical High $295.12 | Professional | None | $229.09 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $660.69 | Facility | None | $489.78 | $575.44 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | None | $239.88 | $239.88 | $245.47 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $275.42 | Facility | None | $245.47 | $245.47 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $758.58 | Professional | None | $199.53 | $457.09 | $758.58 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $416.87 | Professional | None | $173.78 | $263.03 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
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 $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $29.51 |
Where New Hampshire sits
The same service costs 2.9 times more in Montana than in Delaware. 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· 24th of 51
$245
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.