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 $50.12 Median $87.10 Typical High $2,398.83 | Facility | None | $50.12 | $87.10 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $199.53 | Professional | None | $50.12 | $87.10 | $199.53 |
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 $48.98 Median $102.33 Typical High $213.80 | Professional | None | $48.98 | $102.33 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $151.36 Typical High $281.84 | Professional | 50 · Both sides | $95.50 | $151.36 | $281.84 |
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 $77.62 Median $194.98 Typical High $416.87 | Professional | None | $77.62 | $194.98 | $416.87 |
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 $64.57 Median $181.97 Typical High $489.78 | Professional | None | $64.57 | $181.97 | $489.78 |
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 $77.62 Median $151.36 Typical High $331.13 | Professional | None | $77.62 | $151.36 | $331.13 |
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 $25.12 Median $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $25.12 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.14 Typical High $17.38 | Professional | 53 · Discontinued | $10.00 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $56.23 Typical High $64.57 | Professional | 54 · Surgery only | $38.02 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $11.22 Typical High $12.88 | Professional | 55 · Aftercare only | $7.59 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.59 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.01 | $7.59 | $8.71 |
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· 28th of 51
$132
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.