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 $60.26 Median $177.83 Typical High $2,398.83 | Facility | None | $60.26 | $177.83 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $331.13 | Professional | None | $50.12 | $125.89 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | None | $138.04 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $199.53 | Professional | None | $41.69 | $87.10 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $131.83 Typical High $245.47 | Professional | 50 · Both sides | $85.11 | $131.83 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $181.97 Typical High $398.11 | Professional | None | $63.10 | $181.97 | $398.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $169.82 Typical High $416.87 | Professional | None | $52.48 | $169.82 | $416.87 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
United Setting Professional Modifier None Typical Low $67.61 Median $186.21 Typical High $363.08 | Professional | None | $67.61 | $186.21 | $363.08 |
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 $23.44 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $23.44 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $9.33 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $95.50 Typical High $134.90 | Professional | 54 · Surgery only | $34.67 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $7.08 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $12.59 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.68 | $12.59 | $17.78 |
Where New Hampshire sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 37th of 51
$126
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.