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 $194.98 Median $251.19 Typical High $251.19 | Professional | None | $194.98 | $251.19 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $562.34 | Facility | None | $416.87 | $489.78 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | RR · Rental | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $645.65 | Professional | None | $173.78 | $389.05 | $645.65 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $363.08 | Professional | None | $147.91 | $223.87 | $363.08 |
Well Sense Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
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 $97.72 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $25.12 | $25.12 |
Where New Hampshire sits
The same service costs 3.6 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· 35th of 51
$219
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.