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 $181.97 Median $234.42 Typical High $234.42 | Professional | None | $181.97 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $446.68 Typical High $524.81 | Facility | None | $389.05 | $446.68 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | UE · Used equipment | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $588.84 | Professional | None | $181.97 | $363.08 | $588.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $338.84 | Professional | None | $138.04 | $208.93 | $338.84 |
Well Sense Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
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 $91.20 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $23.44 |
Where New Hampshire sits
The same service costs 2.7 times more in Montana 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
$219
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.