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 $354.81 Median $457.09 Typical High $457.09 | Professional | None | $354.81 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $1,023.29 | Facility | None | $741.31 | $870.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | UE · Used equipment | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $1,148.15 | Professional | None | $371.54 | $707.95 | $1,148.15 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $660.69 | Professional | None | $269.15 | $398.11 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
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 $177.83 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $45.71 |
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· 45th of 51
$457
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.