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 $4.47 Median $186.21 Typical High $186.21 | Professional | None | $4.47 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $2.24 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $0.89 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $0.68 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $169.82 | Professional | None | $102.33 | $102.33 | $169.82 |
1 more rate 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 56 · Pre-op care only Typical Low $9.77 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.77 | $18.62 | $18.62 |
Where New Hampshire sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 16th of 51
$102
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.