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 $7.41 Median $10.23 Typical High $10.23 | Professional | None | $7.41 | $10.23 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | RR · Rental | $1.20 | $1.20 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | UE · Used equipment | $8.91 | $8.91 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $5.01 Median $10.23 Typical High $14.13 | Professional | None | $5.01 | $10.23 | $14.13 |
United Setting Professional Modifier None Typical Low $4.57 Median $5.75 Typical High $9.55 | Professional | None | $4.57 | $5.75 | $9.55 |
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 $5.13 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 54 · Surgery only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $1.02 | $1.02 | $1.02 |
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· 13th of 51
$10.23
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.