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 $758.58 Median $977.24 Typical High $977.24 | Professional | None | $758.58 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,584.89 | $1,862.09 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | UE · Used equipment | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,318.26 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $2,454.71 | Professional | None | $831.76 | $1,513.56 | $2,454.71 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Facility | None | $645.65 | $645.65 | $831.76 |
United Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,412.54 | Professional | None | $575.44 | $851.14 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $380.19 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $97.72 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Pennsylvania. 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
$1,000
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.