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 $104.71 Median $134.90 Typical High $134.90 | Professional | None | $104.71 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $263.03 Typical High $302.00 | Facility | None | $223.87 | $263.03 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | RR · Rental | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | UE · Used equipment | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $190.55 | Facility | None | $107.15 | $169.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $346.74 | Professional | None | $117.49 | $208.93 | $346.74 |
United Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $134.90 | Facility | None | $112.20 | $125.89 | $134.90 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $194.98 | Professional | None | $79.43 | $120.23 | $194.98 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $56.23 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $22.39 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $13.49 |
Where New Hampshire sits
The same service costs 2.7 times more in Kansas 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· 26th of 51
$182
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.