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 $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,137.96 | $2,511.89 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | RR · Rental | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | UE · Used equipment | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $891.25 Median $1,995.26 Typical High $3,311.31 | Professional | None | $891.25 | $1,995.26 | $3,311.31 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Facility | None | $977.24 | $977.24 | $1,148.15 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,862.09 | Professional | None | $758.58 | $1,148.15 | $1,862.09 |
Well Sense Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $501.19 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $128.82 |
Where New Hampshire sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 36th of 51
$1,047
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.