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 $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | UE · Used equipment | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.42 Median $41.69 Typical High $57.54 | Professional | None | $20.42 | $41.69 | $57.54 |
United Setting Professional Modifier None Typical Low $18.62 Median $23.44 Typical High $38.02 | Professional | None | $18.62 | $23.44 | $38.02 |
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 $23.44 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 54 · Surgery only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.68 |
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· 13th of 51
$41.69
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.