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 $22.39 Median $39.81 Typical High $2,398.83 | Facility | None | $22.39 | $39.81 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $70.79 | Professional | None | $22.39 | $37.15 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
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 $21.38 Median $42.66 Typical High $72.44 | Professional | None | $21.38 | $42.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $54.95 Typical High $109.65 | Professional | None | $25.70 | $54.95 | $109.65 |
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 $32.36 Median $61.66 Typical High $141.25 | Professional | None | $32.36 | $61.66 | $141.25 |
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 $31.62 Median $57.54 Typical High $107.15 | Professional | None | $31.62 | $57.54 | $107.15 |
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 $10.23 Median $16.98 Typical High $25.12 | Professional | 52 · Reduced service | $10.23 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $6.92 Typical High $10.00 | Professional | 53 · Discontinued | $4.17 | $6.92 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $25.70 Typical High $38.02 | Professional | 54 · Surgery only | $15.49 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $5.13 Typical High $7.59 | Professional | 55 · Aftercare only | $3.09 | $5.13 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.04 | $3.47 | $5.01 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 19th of 51
$48.98
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.