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 $4.57 Median $6.46 Typical High $6.46 | Professional | None | $4.57 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | RR · Rental | $0.55 | $0.55 | $0.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | UE · Used equipment | $4.17 | $4.17 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.34 Median $4.68 Typical High $6.61 | Professional | None | $2.34 | $4.68 | $6.61 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.69 Typical High $4.37 | Professional | None | $2.09 | $2.69 | $4.37 |
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 $3.24 Median $3.24 Typical High $3.24 | Professional | 52 · Reduced service | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 53 · Discontinued | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 54 · Surgery only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.65 | $0.65 | $0.65 |
Where New Hampshire sits
The same service costs 3.8 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
$4.68
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.