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 $42.66 Median $61.66 Typical High $8,912.51 | Facility | None | $42.66 | $61.66 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $93.33 | Professional | None | $42.66 | $61.66 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | None | $50.12 | $50.12 | $52.48 |
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 $35.48 Median $48.98 Typical High $67.61 | Professional | None | $35.48 | $48.98 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $575.44 | Facility | None | $42.66 | $56.23 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $154.88 | Professional | None | $52.48 | $77.62 | $154.88 |
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 $41.69 Median $72.44 Typical High $134.90 | Professional | None | $41.69 | $72.44 | $134.90 |
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 $43.65 Median $74.13 Typical High $131.83 | Professional | None | $43.65 | $74.13 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
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 $21.38 Median $24.55 Typical High $30.90 | Professional | 52 · Reduced service | $21.38 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.77 Typical High $12.59 | Professional | 53 · Discontinued | $8.51 | $9.77 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $36.31 Typical High $46.77 | Professional | 54 · Surgery only | $32.36 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.24 Typical High $9.33 | Professional | 55 · Aftercare only | $6.46 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.27 | $4.90 | $6.17 |
Where New Hampshire sits
The same service costs 4.2 times more in Alaska 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· 28th of 51
$58.88
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.