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 $295.12 Median $380.19 Typical High $380.19 | Professional | None | $295.12 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $724.44 Typical High $851.14 | Facility | None | $616.60 | $724.44 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | RR · Rental | $40.74 | $40.74 | $40.74 |
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 $524.81 Median $524.81 Typical High $588.84 | Facility | None | $524.81 | $524.81 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $954.99 | Professional | None | $316.23 | $588.84 | $954.99 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $549.54 | Professional | None | $223.87 | $338.84 | $549.54 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
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 $147.91 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $38.02 |
Where New Hampshire sits
The same service costs 2.3 times more in Hawaii 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· 31st of 51
$407
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.