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 $120.23 Median $208.93 Typical High $9,772.37 | Facility | None | $120.23 | $208.93 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $208.93 | Professional | None | $85.11 | $120.23 | $208.93 |
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 $38.02 Median $77.62 Typical High $95.50 | Professional | None | $38.02 | $77.62 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | 50 · Both sides | $91.20 | $120.23 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $575.44 | Facility | None | $70.79 | $93.33 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $229.09 | Professional | None | $61.66 | $120.23 | $229.09 |
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 $45.71 Median $95.50 Typical High $229.09 | Professional | None | $45.71 | $95.50 | $229.09 |
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 $60.26 Median $104.71 Typical High $239.88 | Professional | None | $60.26 | $104.71 | $239.88 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
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 $46.77 Median $60.26 Typical High $104.71 | Professional | 52 · Reduced service | $46.77 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $23.99 Typical High $41.69 | Professional | 53 · Discontinued | $18.62 | $23.99 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $89.13 Typical High $154.88 | Professional | 54 · Surgery only | $69.18 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.78 Typical High $30.90 | Professional | 55 · Aftercare only | $14.13 | $17.78 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.02 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.33 | $12.02 | $20.89 |
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· 37th of 51
$83.18
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.