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 $467.74 Median $602.56 Typical High $1,096.48 | Professional | None | $467.74 | $602.56 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,348.96 | Facility | None | $1,000.00 | $1,174.90 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | None | $537.03 | $549.54 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | UE · Used equipment | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $933.25 Typical High $1,548.82 | Professional | None | $407.38 | $933.25 | $1,548.82 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $870.96 | Professional | None | $354.81 | $537.03 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $234.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $46.77 | $60.26 | $60.26 |
Where New Hampshire sits
The same service costs 2.4 times more in Iowa 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· 28th of 51
$550
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.