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 $162.18 Median $208.93 Typical High $380.19 | Professional | None | $162.18 | $208.93 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $467.74 | Facility | None | $346.74 | $398.11 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $234.42 | Facility | None | $208.93 | $208.93 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $524.81 | Professional | None | $154.88 | $323.59 | $524.81 |
United Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $295.12 | Professional | None | $123.03 | $186.21 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
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 $81.28 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $20.89 |
Where New Hampshire sits
The same service costs 2.4 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· 28th of 51
$224
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.