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 (both parts) Typical Low $77.62 Median $87.10 Typical High $112.20 | Professional | None (both parts) | $77.62 | $87.10 | $112.20 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | TC · Technical part | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $70.79 Median $97.72 Typical High $204.17 | Professional | None (both parts) | $70.79 | $97.72 | $204.17 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | TC · Technical part | $97.72 | $97.72 | $123.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $100.00 Typical High $245.47 | Professional | None (both parts) | $93.33 | $100.00 | $245.47 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $77.62 Median $125.89 Typical High $245.47 | Professional | None (both parts) | $77.62 | $125.89 | $245.47 |
United Setting Professional Modifier None (both parts) Typical Low $95.50 Median $151.36 Typical High $316.23 | Professional | None (both parts) | $95.50 | $151.36 | $316.23 |
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 $40.74 Median $45.71 Typical High $46.77 | Professional | 52 · Reduced service | $40.74 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $18.62 | Professional | 53 · Discontinued | $16.60 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.13 | $9.12 | $9.33 |
Where New Hampshire sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$117
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.