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 Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | None | $117.49 | $144.54 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | RR · Rental | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | UE · Used equipment | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Facility | None | $194.98 | $194.98 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $371.54 | Professional | None | $117.49 | $223.87 | $371.54 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $208.93 | Professional | None | $85.11 | $128.82 | $208.93 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
2 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 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $14.45 | $14.45 |
Where New Hampshire sits
The same service costs 2.6 times more in Montana than in New York. 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· 45th of 51
$145
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.