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 $63.10 Median $125.89 Typical High $9,772.37 | Facility | None | $63.10 | $125.89 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $125.89 | Professional | None | $45.71 | $85.11 | $125.89 |
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 $25.12 Median $74.13 Typical High $131.83 | Professional | None | $25.12 | $74.13 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $141.25 | Facility | None | $79.43 | $107.15 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $229.09 | Professional | None | $38.02 | $97.72 | $229.09 |
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 $34.67 Median $91.20 Typical High $245.47 | Professional | None | $34.67 | $91.20 | $245.47 |
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 $42.66 Median $95.50 Typical High $199.53 | Professional | None | $42.66 | $95.50 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
6 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 $31.62 Median $44.67 Typical High $63.10 | Professional | 52 · Reduced service | $31.62 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $17.78 Typical High $25.12 | Professional | 53 · Discontinued | $12.88 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $66.07 Typical High $93.33 | Professional | 54 · Surgery only | $47.86 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $9.55 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.91 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.31 | $8.91 | $12.59 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 58 · Staged procedure | $109.65 | $109.65 | $109.65 |
Where New Hampshire sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 32nd 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.