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 $239.88 Median $309.03 Typical High $309.03 | Professional | None | $239.88 | $309.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $588.84 Typical High $691.83 | Facility | None | $512.86 | $588.84 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | RR · Rental | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | UE · Used equipment | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $398.11 | Facility | None | $363.08 | $363.08 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $251.19 Median $478.63 Typical High $776.25 | Professional | None | $251.19 | $478.63 | $776.25 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $446.68 | Professional | None | $181.97 | $275.42 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
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 $120.23 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $30.90 |
Where New Hampshire sits
The same service costs 2.2 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· 33rd of 51
$302
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.