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 $398.11 Median $512.86 Typical High $512.86 | Professional | None | $398.11 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,174.90 | Facility | None | $851.14 | $1,000.00 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | RR · Rental | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | UE · Used equipment | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $812.83 Typical High $1,318.26 | Professional | None | $363.08 | $812.83 | $1,318.26 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
United Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $741.31 | Professional | None | $309.03 | $457.09 | $741.31 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
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 $199.53 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $51.29 | $51.29 |
Where New Hampshire sits
The same service costs 3.0 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· 34th of 51
$427
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.