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 $56.23 Median $79.43 Typical High $2,398.83 | Facility | None | $56.23 | $79.43 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $144.54 | Professional | None | $56.23 | $79.43 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $97.72 Typical High $151.36 | Professional | None | $20.89 | $97.72 | $151.36 |
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 $64.57 Median $100.00 Typical High $208.93 | Professional | None | $64.57 | $100.00 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $275.42 | Professional | None | $77.62 | $147.91 | $275.42 |
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 $57.54 Median $125.89 Typical High $316.23 | Professional | None | $57.54 | $125.89 | $316.23 |
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 $69.18 Median $120.23 Typical High $223.87 | Professional | None | $69.18 | $120.23 | $223.87 |
Well Sense Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Facility | None | $61.66 | $61.66 | $74.13 |
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 $28.18 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $28.18 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $11.22 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $54.95 Typical High $58.88 | Professional | 54 · Surgery only | $41.69 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $7.94 |
Where New Hampshire sits
The same service costs 3.2 times more in Alaska than in New York. 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· 17th of 51
$115
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.