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 $512.86 Median $660.69 Typical High $660.69 | Professional | None | $512.86 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,479.11 | Facility | None | $1,071.52 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | None | $537.03 | $537.03 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | UE · Used equipment | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Facility | None | $616.60 | $616.60 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $1,659.59 | Professional | None | $457.09 | $1,023.29 | $1,659.59 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $954.99 | Professional | None | $389.05 | $588.84 | $954.99 |
Well Sense Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
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 $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
Where New Hampshire sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 32nd of 51
$550
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.