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 $204.17 Median $281.84 Typical High $281.84 | Professional | None | $204.17 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $549.54 Typical High $645.65 | Facility | None | $467.74 | $549.54 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | None | $275.42 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $27.54 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $446.68 Typical High $724.44 | Professional | None | $194.98 | $446.68 | $724.44 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $407.38 | Professional | None | $181.97 | $251.19 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
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 $109.65 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $28.18 | $28.18 |
Where New Hampshire sits
The same service costs 2.5 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· 27th of 51
$282
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.