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 $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | RR · Rental | $7.59 | $7.59 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | UE · Used equipment | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $31.62 Median $64.57 Typical High $89.13 | Professional | None | $31.62 | $64.57 | $89.13 |
United Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $60.26 | Professional | None | $28.84 | $37.15 | $60.26 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
Where New Hampshire sits
The same service costs 2.8 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· 17th of 51
$60.26
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.