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 $7.59 Median $10.47 Typical High $10.47 | Professional | None | $7.59 | $10.47 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | RR · Rental | $0.85 | $0.85 | $0.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | UE · Used equipment | $6.46 | $6.46 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.63 Median $7.41 Typical High $10.23 | Professional | None | $3.63 | $7.41 | $10.23 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.17 Typical High $6.92 | Professional | None | $3.31 | $4.17 | $6.92 |
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 $5.25 Median $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 54 · Surgery only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.05 |
Where New Hampshire sits
The same service costs 4.1 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· 14th of 51
$7.41
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.