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 $64.57 Median $83.18 Typical High $89.13 | Professional | None | $64.57 | $83.18 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $186.21 | Facility | None | $138.04 | $162.18 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None | $85.11 | $87.10 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | RR · Rental | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $125.89 | Facility | None | $102.33 | $102.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $213.80 | Professional | None | $64.57 | $128.82 | $213.80 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $120.23 | Professional | None | $52.48 | $74.13 | $120.23 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
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 $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $8.32 |
Where New Hampshire sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 40th of 51
$85.11
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.