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 $35.48 Median $56.23 Typical High $56.23 | Professional | None | $35.48 | $56.23 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $63.10 | Professional | None | $51.29 | $60.26 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $44.67 Typical High $63.10 | Professional | None | $22.39 | $44.67 | $63.10 |
United Setting Professional Modifier None Typical Low $19.95 Median $25.70 Typical High $41.69 | Professional | None | $19.95 | $25.70 | $41.69 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 54 · Surgery only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
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· 13th of 51
$44.67
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.