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 $117.49 Median $194.98 Typical High $9,772.37 | Facility | None | $117.49 | $194.98 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $162.18 | Professional | None | $81.28 | $117.49 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $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 $37.15 Median $83.18 Typical High $154.88 | Professional | None | $37.15 | $83.18 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $213.80 | Professional | None | $54.95 | $114.82 | $213.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $218.78 | Professional | None | $45.71 | $100.00 | $218.78 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
United Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $190.55 | Professional | None | $52.48 | $109.65 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | None | $63.10 | $63.10 | $89.13 |
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 $40.74 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $40.74 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $16.60 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $123.03 | Professional | 54 · Surgery only | $61.66 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $24.55 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $16.22 |
Where New Hampshire sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 30th of 51
$93.33
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.