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 $346.74 Median $446.68 Typical High $446.68 | Professional | None | $346.74 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $851.14 Typical High $1,000.00 | Facility | None | $724.44 | $851.14 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | RR · Rental | $36.31 | $36.31 | $36.31 |
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 $398.11 Median $398.11 Typical High $446.68 | Facility | None | $398.11 | $398.11 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $1,122.02 | Professional | None | $309.03 | $691.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $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 $173.78 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $44.67 |
Where New Hampshire sits
The same service costs 3.7 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· 33rd of 51
$380
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.