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 $97.72 Median $125.89 Typical High $125.89 | Professional | None | $97.72 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $288.40 | Facility | None | $208.93 | $245.47 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | RR · Rental | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $190.55 | Facility | None | $169.82 | $169.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $323.59 | Professional | None | $102.33 | $199.53 | $323.59 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Facility | None | $107.15 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $181.97 | Professional | None | $75.86 | $112.20 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
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 $48.98 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $12.59 |
Where New Hampshire sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 41st of 51
$123
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.