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 $245.47 Typical High $245.47 | Professional | None | $194.98 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $549.54 | Facility | None | $407.38 | $467.74 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | UE · Used equipment | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $616.60 | Professional | None | $204.17 | $380.19 | $616.60 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $354.81 | Professional | None | $144.54 | $218.78 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $24.55 |
Where New Hampshire sits
The same service costs 2.5 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· 34th of 51
$245
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.