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 $3.98 Median $6.61 Typical High $9,772.37 | Facility | None | $3.98 | $6.61 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $6.17 Typical High $12.02 | Professional | None | $2.19 | $6.17 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $9.12 Typical High $13.18 | Professional | None | $5.13 | $9.12 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $6.03 Typical High $8.13 | Professional | None | $1.00 | $6.03 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $2,691.53 | Facility | None | $100.00 | $100.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $7.41 Typical High $17.38 | Professional | None | $2.19 | $7.41 | $17.38 |
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 $2.69 Median $6.92 Typical High $17.38 | Professional | None | $2.69 | $6.92 | $17.38 |
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 $2.88 Median $7.41 Typical High $14.13 | Professional | None | $2.88 | $7.41 | $14.13 |
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 $1.02 Median $2.45 Typical High $3.47 | Professional | 52 · Reduced service | $1.02 | $2.45 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.98 Typical High $1.38 | Professional | 53 · Discontinued | $0.41 | $0.98 | $1.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.51 Median $3.63 Typical High $5.25 | Professional | 54 · Surgery only | $1.51 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.72 Typical High $1.05 | Professional | 55 · Aftercare only | $0.30 | $0.72 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.49 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.20 | $0.49 | $0.69 |
Where New Hampshire sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 32nd of 51
$6.31
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.