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 Facility Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $177.83 | Professional | None | $63.10 | $120.23 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $169.82 | Professional | None | $45.71 | $100.00 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $151.36 | Facility | None | $89.13 | $120.23 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $309.03 | Professional | None | $87.10 | $162.18 | $309.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $323.59 | Professional | None | $60.26 | $134.90 | $323.59 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $229.09 | Professional | None | $75.86 | $134.90 | $229.09 |
Well Sense Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
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 $30.90 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $30.90 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $12.59 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $46.77 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $9.33 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.31 | $11.48 | $13.18 |
Where New Hampshire sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 26th of 51
$115
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.