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 $97.72 Median $162.18 Typical High $9,772.37 | Facility | None | $97.72 | $162.18 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $162.18 | Professional | None | $74.13 | $112.20 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $47.86 Median $102.33 Typical High $186.21 | Professional | None | $47.86 | $102.33 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $575.44 | Facility | None | $104.71 | $134.90 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $281.84 | Professional | None | $66.07 | $125.89 | $281.84 |
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 $61.66 Median $131.83 Typical High $323.59 | Professional | None | $61.66 | $131.83 | $323.59 |
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 $70.79 Median $125.89 Typical High $281.84 | Professional | None | $70.79 | $125.89 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
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 $48.98 Median $48.98 Typical High $81.28 | Professional | 52 · Reduced service | $48.98 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $32.36 | Professional | 53 · Discontinued | $19.50 | $19.50 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $120.23 | Professional | 54 · Surgery only | $74.13 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $24.55 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $16.22 |
Where New Hampshire sits
The same service costs 2.8 times more in Wisconsin 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· 22nd of 51
$117
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.