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 $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | RR · Rental | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | UE · Used equipment | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.72 Median $21.88 Typical High $30.20 | Professional | None | $10.72 | $21.88 | $30.20 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $20.42 | Professional | None | $9.77 | $12.59 | $20.42 |
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 $7.59 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 54 · Surgery only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.51 |
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
$20.42
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.