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 $4,265.80 Median $5,754.40 Typical High $5,754.40 | Professional | None | $4,265.80 | $5,754.40 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | RR · Rental | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,623.41 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,570.88 Median $8,511.38 Typical High $14,125.38 | Professional | None | $4,570.88 | $8,511.38 | $14,125.38 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $7,943.28 | Professional | None | $3,235.94 | $4,897.79 | $7,943.28 |
Well Sense Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | None | $9,772.37 | $9,772.37 | $9,772.37 |
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 $2,137.96 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,137.96 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $851.14 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $426.58 | $575.44 | $575.44 |
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· 44th of 51
$4,898
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.