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 $354.81 Median $446.68 Typical High $446.68 | Professional | None | $354.81 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $851.14 Typical High $1,000.00 | Facility | None | $741.31 | $851.14 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | RR · Rental | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | UE · Used equipment | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $660.69 | Facility | None | $588.84 | $588.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,122.02 | Professional | None | $389.05 | $691.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $645.65 | Professional | None | $263.03 | $398.11 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
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 $177.83 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $44.67 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 38th of 51
$479
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.