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 $501.19 Median $645.65 Typical High $645.65 | Professional | None | $501.19 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,071.52 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | None | $524.81 | $524.81 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | UE · Used equipment | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Facility | None | $588.84 | $588.84 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $1,000.00 Typical High $1,659.59 | Professional | None | $446.68 | $1,000.00 | $1,659.59 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
United Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $933.25 | Professional | None | $380.19 | $575.44 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
Where New Hampshire sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$537
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.