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 $131.83 Median $169.82 Typical High $169.82 | Professional | None | $131.83 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $380.19 | Facility | None | $281.84 | $331.13 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | None | $177.83 | $181.97 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | RR · Rental | $17.78 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $436.52 | Professional | None | $131.83 | $263.03 | $436.52 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $245.47 | Professional | None | $100.00 | $151.36 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
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 $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $16.98 |
Where New Hampshire sits
The same service costs 2.8 times more in Montana 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· 30th of 51
$178
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.