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 $234.42 Median $302.00 Typical High $302.00 | Professional | None | $234.42 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $676.08 | Facility | None | $489.78 | $575.44 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | RR · Rental | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Facility | None | $309.03 | $309.03 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $758.58 | Professional | None | $208.93 | $467.74 | $758.58 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $245.47 | Facility | None | $218.78 | $218.78 | $245.47 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $426.58 | Professional | None | $177.83 | $263.03 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
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 $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $30.20 |
Where New Hampshire sits
The same service costs 2.5 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· 35th of 51
$240
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.