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 $19.05 Median $25.70 Typical High $25.70 | Professional | None | $19.05 | $25.70 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | RR · Rental | $3.39 | $3.39 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.45 Median $28.84 Typical High $40.74 | Professional | None | $14.45 | $28.84 | $40.74 |
United Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $26.92 | Professional | None | $12.88 | $16.60 | $26.92 |
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 $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 54 · Surgery only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
Where New Hampshire sits
The same service costs 2.6 times more in Hawaii 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· 16th of 51
$26.92
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.