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 $323.59 Median $363.08 Typical High $436.52 | Professional | None | $323.59 | $363.08 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $616.60 | Professional | None | $363.08 | $501.19 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,047.13 | Professional | None | $398.11 | $537.03 | $1,047.13 |
United Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $831.76 | Professional | None | $316.23 | $478.63 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | None | $229.09 | $229.09 | $323.59 |
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 $204.17 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $45.71 |
Where New Hampshire sits
The same service costs 2.1 times more in Wyoming 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· 15th of 51
$457
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.