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 $95.50 Median $114.82 Typical High $138.04 | Professional | None | $95.50 | $114.82 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $173.78 | Professional | None | $72.44 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $223.87 Typical High $323.59 | Professional | 50 · Both sides | $151.36 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $204.17 | Facility | None | $100.00 | $162.18 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $346.74 | Professional | None | $114.82 | $186.21 | $346.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $323.59 | Professional | None | $87.10 | $162.18 | $323.59 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $288.40 | Professional | None | $107.15 | $162.18 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
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 $47.86 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $19.50 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $13.80 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 20th of 51
$141
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.