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 $3,981.07 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,981.07 | $5,128.61 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $10,000.00 Typical High $11,481.54 | Facility | None | $8,511.38 | $10,000.00 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | RR · Rental | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,981.07 Median $7,943.28 Typical High $13,182.57 | Professional | None | $3,981.07 | $7,943.28 | $13,182.57 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Facility | None | $3,801.89 | $3,801.89 | $4,466.84 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $7,413.10 | Professional | None | $3,019.95 | $4,570.88 | $7,413.10 |
Well Sense Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
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 $1,995.26 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,995.26 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $602.56 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $398.11 | $512.86 | $512.86 |
Where New Hampshire sits
The same service costs 2.1 times more in Montana 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· 39th of 51
$4,898
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.