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 $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Facility | None | $537.03 | $630.96 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | RR · Rental | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | UE · Used equipment | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Facility | None | $501.19 | $501.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $831.76 | Professional | None | $288.40 | $512.86 | $831.76 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $478.63 | Professional | None | $194.98 | $288.40 | $478.63 |
Well Sense Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
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 $131.83 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $33.11 | $33.11 |
Where New Hampshire sits
The same service costs 3.0 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· 47th of 51
$355
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.