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 $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | RR · Rental | $0.83 | $0.83 | $0.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | UE · Used equipment | $6.17 | $6.17 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.55 Median $7.08 Typical High $9.77 | Professional | None | $3.55 | $7.08 | $9.77 |
United Setting Professional Modifier None Typical Low $3.16 Median $4.07 Typical High $6.61 | Professional | None | $3.16 | $4.07 | $6.61 |
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 $4.17 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 53 · Discontinued | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 54 · Surgery only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $0.83 |
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· 14th of 51
$7.08
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.