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 $645.65 Median $831.76 Typical High $831.76 | Professional | None | $645.65 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,862.09 | Facility | None | $1,348.96 | $1,584.89 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | RR · Rental | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | UE · Used equipment | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Facility | None | $1,047.13 | $1,047.13 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $2,089.30 | Professional | None | $691.83 | $1,288.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,202.26 | Professional | None | $489.78 | $724.44 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $323.59 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $83.18 |
Where New Hampshire sits
The same service costs 3.1 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· 33rd of 51
$832
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.