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 $57.54 Median $91.20 Typical High $151.36 | Facility | None | $57.54 | $91.20 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $112.20 | Professional | None | $56.23 | $85.11 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $109.65 | Professional | None | $38.02 | $74.13 | $109.65 |
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 $39.81 Median $69.18 Typical High $112.20 | Professional | None | $39.81 | $69.18 | $112.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $134.90 Typical High $213.80 | Professional | 50 · Both sides | $95.50 | $134.90 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $575.44 | Facility | None | $58.88 | $77.62 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $177.83 | Professional | None | $64.57 | $95.50 | $177.83 |
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 $47.86 Median $85.11 Typical High $165.96 | Professional | None | $47.86 | $85.11 | $165.96 |
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 $58.88 Median $85.11 Typical High $144.54 | Professional | None | $58.88 | $85.11 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
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 $28.18 Median $28.84 Typical High $45.71 | Professional | 52 · Reduced service | $28.18 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.48 Typical High $18.20 | Professional | 53 · Discontinued | $11.22 | $11.48 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $43.65 Typical High $69.18 | Professional | 54 · Surgery only | $41.69 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $13.80 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $9.12 |
Where New Hampshire sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 18th of 51
$81.28
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.