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 $12.88 Median $14.13 Typical High $14.13 | Professional | None | $12.88 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $35.48 | Professional | None | $15.14 | $19.05 | $35.48 |
United Setting Professional Modifier None Typical Low $14.45 Median $19.50 Typical High $38.02 | Professional | None | $14.45 | $19.50 | $38.02 |
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 |
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 $6.46 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $6.46 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.57 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $1.95 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.29 | $1.45 | $1.45 |
Where New Hampshire sits
The same service costs 4.9 times more in Alaska than in Connecticut. 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· 36th of 51
$14.13
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.