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 $363.08 Median $467.74 Typical High $467.74 | Professional | None | $363.08 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,047.13 | Facility | None | $776.25 | $912.01 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | None | $380.19 | $389.05 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | RR · Rental | $38.02 | $38.02 | $38.02 |
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 $524.81 Median $524.81 Typical High $645.65 | Facility | None | $524.81 | $524.81 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $1,202.26 | Professional | None | $316.23 | $724.44 | $1,202.26 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $676.08 | Professional | None | $275.42 | $416.87 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
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 $181.97 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $46.77 |
Where New Hampshire sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 31st of 51
$389
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.