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 $269.15 Median $346.74 Typical High $346.74 | Professional | None | $269.15 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $660.69 Typical High $776.25 | Facility | None | $575.44 | $660.69 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | RR · Rental | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | UE · Used equipment | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Facility | None | $398.11 | $398.11 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $870.96 | Professional | None | $269.15 | $537.03 | $870.96 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $501.19 | Professional | None | $204.17 | $309.03 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
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 $134.90 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $34.67 |
Where New Hampshire sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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
$324
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.