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 $50.12 Median $77.62 Typical High $114.82 | Facility | None | $50.12 | $77.62 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $117.49 | Professional | None | $50.12 | $75.86 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $97.72 | Professional | None | $79.43 | $81.28 | $97.72 |
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 $41.69 Median $81.28 Typical High $100.00 | Professional | None | $41.69 | $81.28 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $128.82 Typical High $165.96 | Professional | 50 · Both sides | $83.18 | $128.82 | $165.96 |
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 $58.88 Median $102.33 Typical High $173.78 | Professional | None | $58.88 | $102.33 | $173.78 |
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 $46.77 Median $87.10 Typical High $190.55 | Professional | None | $46.77 | $87.10 | $190.55 |
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 $50.12 Median $85.11 Typical High $151.36 | Professional | None | $50.12 | $85.11 | $151.36 |
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 $24.55 Median $30.90 Typical High $39.81 | Professional | 52 · Reduced service | $24.55 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.30 Typical High $15.85 | Professional | 53 · Discontinued | $10.00 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.17 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.01 | $6.17 | $7.94 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 14th 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.