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 $186.21 Median $239.88 Typical High $239.88 | Professional | None | $186.21 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $457.09 Typical High $537.03 | Facility | None | $389.05 | $457.09 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | RR · Rental | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | UE · Used equipment | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Facility | None | $218.78 | $218.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $602.56 | Professional | None | $165.96 | $371.54 | $602.56 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $169.82 | Facility | None | $36.31 | $36.31 | $169.82 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $338.84 | Professional | None | $141.25 | $208.93 | $338.84 |
Well Sense Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
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 $93.33 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $23.99 |
Where New Hampshire sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 37th of 51
$204
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.