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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $138.04 | Professional | None | $51.29 | $85.11 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $40.74 Median $72.44 Typical High $138.04 | Professional | None | $40.74 | $72.44 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $100.00 | Facility | None | $51.29 | $70.79 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $190.55 | Professional | None | $69.18 | $112.20 | $190.55 |
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 $53.70 Median $95.50 Typical High $223.87 | Professional | None | $53.70 | $95.50 | $223.87 |
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 $63.10 Median $93.33 Typical High $194.98 | Professional | None | $63.10 | $93.33 | $194.98 |
Well Sense Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
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 $25.70 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $25.70 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $10.23 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $60.26 Typical High $63.10 | Professional | 54 · Surgery only | $38.02 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.13 | $7.94 | $8.51 |
Where New Hampshire sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$85.11
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.