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 $102.33 Median $131.83 Typical High $134.90 | Professional | None | $102.33 | $131.83 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $251.19 Typical High $295.12 | Facility | None | $218.78 | $251.19 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | UE · Used equipment | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Facility | None | $151.36 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $331.13 | Professional | None | $97.72 | $204.17 | $331.13 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $186.21 | Professional | None | $77.62 | $117.49 | $186.21 |
Well Sense Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
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 $51.29 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $13.18 |
Where New Hampshire sits
The same service costs 2.1 times more in Hawaii than in Utah. 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· 48th of 51
$117
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.