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 $112.20 Median $190.55 Typical High $8,912.51 | Facility | None | $112.20 | $190.55 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
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 $48.98 Median $102.33 Typical High $154.88 | Professional | None | $48.98 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $154.88 Typical High $229.09 | Professional | 50 · Both sides | $117.49 | $154.88 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $575.44 | Facility | None | $128.82 | $169.82 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $275.42 | Professional | None | $77.62 | $162.18 | $275.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $302.00 | Professional | None | $58.88 | $131.83 | $302.00 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $269.15 | Professional | None | $75.86 | $144.54 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
6 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 $53.70 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $53.70 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $21.38 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $79.43 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $19.05 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 59 · Distinct service | $77.62 | $77.62 | $77.62 |
Where New Hampshire sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 27th of 51
$123
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.