How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | None | $61.66 | $61.66 | $63.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $239.88 | Professional | None | $95.50 | $128.82 | $239.88 |
United Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $239.88 | Professional | None | $95.50 | $125.89 | $239.88 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Facility | None | $3,630.78 | $3,630.78 | $5,754.40 |
4 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 $42.66 Median $42.66 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.55 |
Where New Hampshire sits
The same service costs 3.2 times more in Alaska 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· 21st of 51
$95.50
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.