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 $18.62 Median $28.18 Typical High $28.18 | Professional | None | $18.62 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | RR · Rental | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | UE · Used equipment | $19.50 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.22 Median $22.39 Typical High $31.62 | Professional | None | $11.22 | $22.39 | $31.62 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $20.89 | Professional | None | $10.00 | $12.88 | $20.89 |
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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 54 · Surgery only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where New Hampshire sits
The same service costs 3.5 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
$22.39
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.