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 Facility Modifier None Typical Low $26.92 Median $39.81 Typical High $97.72 | Facility | None | $26.92 | $39.81 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $51.29 | Professional | None | $26.30 | $39.81 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $26.30 Typical High $53.70 | Professional | None | $13.49 | $26.30 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $45.71 Typical High $100.00 | Professional | None | $20.89 | $45.71 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $48.98 Typical High $117.49 | Professional | None | $25.70 | $48.98 | $117.49 |
United Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $58.88 | Professional | None | $23.99 | $38.90 | $58.88 |
2 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 55 · Aftercare only Typical Low $3.89 Median $6.03 Typical High $7.59 | Professional | 55 · Aftercare only | $3.89 | $6.03 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.98 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.57 | $3.98 | $5.01 |
Where New Hampshire sits
The same service costs 2.5 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· 33rd of 51
$37.15
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.