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 $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $338.84 | Facility | None | $199.53 | $251.19 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $346.74 | Professional | None | $125.89 | $141.25 | $346.74 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,365.16 | Facility | None | $3,630.78 | $3,630.78 | $4,365.16 |
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 $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Where New Hampshire sits
The same service costs 26.9 times more in Kansas 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· 39th of 51
$126
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.