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 $83.18 Median $223.87 Typical High $8,912.51 | Facility | None | $83.18 | $223.87 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $281.84 | Professional | None | $83.18 | $162.18 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $181.97 | Professional | None | $70.79 | $70.79 | $181.97 |
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 $93.33 Median $151.36 Typical High $223.87 | Professional | None | $93.33 | $151.36 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $229.09 Typical High $331.13 | Professional | 50 · Both sides | $151.36 | $229.09 | $331.13 |
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 $123.03 Median $245.47 Typical High $407.38 | Professional | None | $123.03 | $245.47 | $407.38 |
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 $83.18 Median $194.98 Typical High $436.52 | Professional | None | $83.18 | $194.98 | $436.52 |
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 $91.20 Median $208.93 Typical High $398.11 | Professional | None | $91.20 | $208.93 | $398.11 |
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 $41.69 Median $74.13 Typical High $112.20 | Professional | 52 · Reduced service | $41.69 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $29.51 Typical High $44.67 | Professional | 53 · Discontinued | $16.60 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $112.20 Typical High $165.96 | Professional | 54 · Surgery only | $61.66 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $22.39 Typical High $33.11 | Professional | 55 · Aftercare only | $12.30 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.79 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.32 | $14.79 | $22.39 |
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· 17th of 51
$182
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.