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 Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $363.08 | Facility | None | $147.91 | $147.91 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | None | $147.91 | $147.91 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $616.60 | Facility | None | $186.21 | $281.84 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | None | $147.91 | $147.91 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $398.11 | Facility | None | $234.42 | $295.12 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $204.17 | Professional | None | $134.90 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $288.40 | Professional | None | $134.90 | $138.04 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
5 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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | JW · Drug discarded | $302.00 | $302.00 | $302.00 |
Where New Hampshire sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 37th of 51
$148
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.