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 $151.36 Median $194.98 Typical High $194.98 | Professional | None | $151.36 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $380.19 Typical High $436.52 | Facility | None | $323.59 | $380.19 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | None | $194.98 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | UE · Used equipment | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Facility | None | $204.17 | $204.17 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $501.19 | Professional | None | $162.18 | $302.00 | $501.19 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Facility | None | $181.97 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $281.84 | Professional | None | $114.82 | $173.78 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $75.86 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $19.50 |
Where New Hampshire sits
The same service costs 3.3 times more in Hawaii 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· 42nd of 51
$195
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.