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 $295.12 Median $380.19 Typical High $380.19 | Professional | None | $295.12 | $380.19 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | RR · Rental | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | UE · Used equipment | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $588.84 Typical High $954.99 | Professional | None | $302.00 | $588.84 | $954.99 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $537.03 | Professional | None | $223.87 | $331.13 | $537.03 |
Well Sense Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
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 $144.54 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $144.54 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $38.02 |
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· 33rd of 51
$363
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.