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 $95.50 Median $165.96 Typical High $9,772.37 | Facility | None | $95.50 | $165.96 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $165.96 | Professional | None | $72.44 | $97.72 | $165.96 |
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 $97.72 Typical High $154.88 | Professional | None | $47.86 | $97.72 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | 50 · Both sides | $112.20 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $575.44 | Facility | None | $138.04 | $181.97 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $281.84 | Professional | None | $74.13 | $154.88 | $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 $54.95 Median $134.90 Typical High $302.00 | Professional | None | $54.95 | $134.90 | $302.00 |
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 $67.61 Median $134.90 Typical High $263.03 | Professional | None | $67.61 | $134.90 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
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 $47.86 Median $48.98 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.50 Typical High $33.11 | Professional | 53 · Discontinued | $19.05 | $19.50 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $125.89 | Professional | 54 · Surgery only | $72.44 | $72.44 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $25.12 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $16.60 |
Where New Hampshire sits
The same service costs 3.4 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· 25th of 51
$112
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.