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 $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | None | $173.78 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | None | $57.54 | $57.54 | $100.00 |
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 $144.54 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $58.88 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $30.90 |
Where New Hampshire sits
The same service costs 25.1 times more in North Dakota than in West Virginia. 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· 24th of 51
$204
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.