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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $52.48 | Professional | None | $32.36 | $41.69 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $58.88 | Professional | None | $25.12 | $34.67 | $58.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $28.18 Median $39.81 Typical High $77.62 | Professional | None | $28.18 | $39.81 | $77.62 |
United Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $87.10 | Professional | None | $28.84 | $42.66 | $87.10 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $3.80 |
Where New Hampshire sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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· 15th of 51
$38.02
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.