How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | RR · Rental | $1.66 | $1.66 | $1.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | UE · Used equipment | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.08 Median $14.13 Typical High $19.95 | Professional | None | $7.08 | $14.13 | $19.95 |
United Setting Professional Modifier None Typical Low $6.31 Median $8.13 Typical High $13.18 | Professional | None | $6.31 | $8.13 | $13.18 |
5 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 $8.32 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 54 · Surgery only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $1.66 |
Where New Hampshire sits
The same service costs 3.2 times more in Rhode Island 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· 13th of 51
$14.13
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.