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 $10.00 Median $20.89 Typical High $20.89 | Professional | None | $10.00 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $61.66 Typical High $93.33 | Facility | None | $23.44 | $61.66 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | None | $10.96 | $10.96 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $19.05 Typical High $26.92 | Facility | None | $10.96 | $19.05 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.08 Median $12.02 Typical High $20.89 | Professional | None | $7.08 | $12.02 | $20.89 |
United Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $10.96 | Professional | None | $5.75 | $7.59 | $10.96 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $5.01 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $5.01 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $2.00 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $1.48 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.00 | $2.09 | $2.09 |
Where New Hampshire sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 12th of 51
$10.96
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.