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 $91.20 Median $117.49 Typical High $117.49 | Professional | None | $91.20 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $263.03 | Facility | None | $190.55 | $223.87 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Facility | None | $147.91 | $147.91 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $295.12 | Professional | None | $85.11 | $181.97 | $295.12 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $165.96 | Professional | None | $70.79 | $102.33 | $165.96 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
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 $45.71 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $13.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $11.75 |
Where New Hampshire sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 32nd of 51
$115
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.