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 $14.79 Median $20.42 Typical High $20.42 | Professional | None | $14.79 | $20.42 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $26.92 | Professional | None | $17.78 | $17.78 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | RR · Rental | $2.40 | $2.40 | $2.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | UE · Used equipment | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.00 Median $20.42 Typical High $28.18 | Professional | None | $10.00 | $20.42 | $28.18 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $19.05 | Professional | None | $9.12 | $11.75 | $19.05 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 54 · Surgery only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where New Hampshire sits
The same service costs 2.9 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
$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.