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 $67.61 Median $97.72 Typical High $109.65 | Facility | None | $67.61 | $97.72 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $141.25 | Professional | None | $60.26 | $93.33 | $141.25 |
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 $46.77 Median $77.62 Typical High $123.03 | Professional | None | $46.77 | $77.62 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $117.49 Typical High $165.96 | Professional | 50 · Both sides | $75.86 | $117.49 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $158.49 | Facility | None | $91.20 | $125.89 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $208.93 | Professional | None | $60.26 | $123.03 | $208.93 |
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 $44.67 Median $107.15 Typical High $229.09 | Professional | None | $44.67 | $107.15 | $229.09 |
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 $57.54 Median $102.33 Typical High $190.55 | Professional | None | $57.54 | $102.33 | $190.55 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
4 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 $30.90 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $12.30 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $9.12 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $7.76 | $9.77 |
Where New Hampshire sits
The same service costs 3.8 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· 15th of 51
$97.72
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.