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 $223.87 Median $288.40 Typical High $288.40 | Professional | None | $223.87 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $549.54 Typical High $645.65 | Facility | None | $467.74 | $549.54 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | RR · Rental | $26.92 | $26.92 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | UE · Used equipment | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $407.38 | Facility | None | $363.08 | $363.08 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $724.44 | Professional | None | $218.78 | $446.68 | $724.44 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $416.87 | Professional | None | $169.82 | $251.19 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
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 $109.65 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $28.84 | $28.84 |
Where New Hampshire sits
The same service costs 2.2 times more in Wisconsin 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· 46th of 51
$269
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.