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 $316.23 Median $407.38 Typical High $407.38 | Professional | None | $316.23 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $912.01 | Facility | None | $676.08 | $794.33 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | UE · Used equipment | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $436.52 | Facility | None | $407.38 | $407.38 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $630.96 Typical High $1,047.13 | Professional | None | $295.12 | $630.96 | $1,047.13 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $588.84 | Professional | None | $245.47 | $363.08 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
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 $158.49 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $40.74 |
Where New Hampshire sits
The same service costs 4.3 times more in Hawaii 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· 36th of 51
$380
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.