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 $125.89 Median $154.88 Typical High $154.88 | Professional | None | $125.89 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $346.74 | Facility | None | $251.19 | $295.12 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | RR · Rental | $16.22 | $16.22 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | UE · Used equipment | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Facility | None | $169.82 | $169.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $389.05 | Professional | None | $123.03 | $239.88 | $389.05 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
United Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $223.87 | Professional | None | $102.33 | $138.04 | $223.87 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
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 $63.10 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $25.12 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $15.49 |
Where New Hampshire sits
The same service costs 4.7 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· 38th of 51
$162
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.