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 $8,709.64 Median $11,220.18 Typical High $11,220.18 | Professional | None | $8,709.64 | $11,220.18 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $18,620.87 Median $21,877.62 Typical High $25,118.86 | Facility | None | $18,620.87 | $21,877.62 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,489.63 | Facility | None | $12,589.25 | $12,589.25 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8,709.64 Median $17,378.01 Typical High $28,840.32 | Professional | None | $8,709.64 | $17,378.01 | $28,840.32 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $16,218.10 | Professional | None | $6,606.93 | $10,000.00 | $16,218.10 |
Well Sense Setting Facility Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $19,952.62 | Facility | None | $19,952.62 | $19,952.62 | $19,952.62 |
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 $4,365.16 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $4,365.16 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,737.80 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,318.26 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $870.96 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $870.96 | $1,122.02 | $1,122.02 |
Where New Hampshire sits
The same service costs 2.5 times more in Montana than in Florida. 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
$10,715
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.