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 $112.20 Median $144.54 Typical High $144.54 | Professional | None | $112.20 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $323.59 | Facility | None | $239.88 | $275.42 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | UE · Used equipment | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $154.88 | Facility | None | $144.54 | $144.54 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $363.08 | Professional | None | $100.00 | $223.87 | $363.08 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $204.17 | Professional | None | $85.11 | $128.82 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
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 $56.23 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $56.23 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $14.45 | $14.45 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Florida. 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· 34th of 51
$123
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.