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 $5,623.41 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,623.41 | $7,244.36 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $14,125.38 Typical High $16,218.10 | Facility | None | $12,022.64 | $14,125.38 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | RR · Rental | $741.31 | $741.31 | $741.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | UE · Used equipment | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,772.37 | Facility | None | $9,120.11 | $9,120.11 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6,165.95 Median $11,220.18 Typical High $18,620.87 | Professional | None | $6,165.95 | $11,220.18 | $18,620.87 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $10,471.29 | Professional | None | $4,265.80 | $6,456.54 | $10,471.29 |
Well Sense Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
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 $2,818.38 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $2,818.38 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $1,122.02 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $851.14 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $562.34 | $724.44 | $724.44 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 40th of 51
$7,413
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.