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 $302.00 Median $389.05 Typical High $389.05 | Professional | None | $302.00 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $758.58 Typical High $870.96 | Facility | None | $645.65 | $758.58 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | None | $416.87 | $416.87 | $436.52 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | UE · Used equipment | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Facility | None | $436.52 | $436.52 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,000.00 | Professional | None | $338.84 | $602.56 | $1,000.00 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Facility | None | $257.04 | $257.04 | $346.74 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $562.34 | Professional | None | $229.09 | $346.74 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
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 $154.88 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $38.90 |
Where New Hampshire sits
The same service costs 2.8 times more in Montana than in Florida. 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· 37th of 51
$417
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.