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 $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | RR · Rental | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | UE · Used equipment | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.45 Median $29.51 Typical High $40.74 | Professional | None | $14.45 | $29.51 | $40.74 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $27.54 | Professional | None | $13.18 | $16.98 | $27.54 |
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 $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 54 · Surgery only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
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· 16th of 51
$27.54
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.