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 $34.67 Median $34.67 Typical High $42.66 | Professional | None | $34.67 | $34.67 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | None | $52.48 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | RR · Rental | $3.72 | $3.72 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | UE · Used equipment | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.85 Median $31.62 Typical High $44.67 | Professional | None | $15.85 | $31.62 | $44.67 |
United Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $29.51 | Professional | None | $14.13 | $18.20 | $29.51 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 54 · Surgery only | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where New Hampshire sits
The same service costs 3.1 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· 15th of 51
$31.62
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.