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 $363.08 Median $467.74 Typical High $467.74 | Professional | None | $363.08 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,047.13 | Facility | None | $776.25 | $912.01 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | UE · Used equipment | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $436.52 | Facility | None | $389.05 | $389.05 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $1,202.26 | Professional | None | $323.59 | $724.44 | $1,202.26 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $676.08 | Professional | None | $275.42 | $416.87 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
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 $181.97 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $46.77 |
Where New Hampshire sits
The same service costs 2.6 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· 25th of 51
$457
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.