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 $100.00 Median $117.49 Typical High $9,772.37 | Facility | None | $100.00 | $117.49 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $223.87 | Professional | None | $97.72 | $117.49 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $177.83 | Professional | None | $151.36 | $173.78 | $177.83 |
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 $83.18 Median $141.25 Typical High $239.88 | Professional | None | $83.18 | $141.25 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $575.44 | Facility | None | $104.71 | $138.04 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $380.19 | Professional | None | $134.90 | $213.80 | $380.19 |
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 $107.15 Median $181.97 Typical High $398.11 | Professional | None | $107.15 | $181.97 | $398.11 |
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 $123.03 Median $165.96 Typical High $288.40 | Professional | None | $123.03 | $165.96 | $288.40 |
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 $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $48.98 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.39 Typical High $23.44 | Professional | 53 · Discontinued | $19.95 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.22 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.00 | $11.22 | $11.75 |
Where New Hampshire sits
The same service costs 3.7 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· 18th of 51
$158
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.