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 $83.18 Median $123.03 Typical High $2,398.83 | Facility | None | $83.18 | $123.03 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $173.78 | Professional | None | $60.26 | $100.00 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $79.43 Typical High $102.33 | Professional | None | $38.02 | $79.43 | $102.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $117.49 Typical High $173.78 | Professional | 50 · Both sides | $91.20 | $117.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $575.44 | Facility | None | $83.18 | $109.65 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $186.21 | Professional | None | $60.26 | $112.20 | $186.21 |
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 $194.98 | Professional | None | $45.71 | $95.50 | $194.98 |
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 $56.23 Median $102.33 Typical High $177.83 | Professional | None | $56.23 | $102.33 | $177.83 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
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 $37.15 Median $50.12 Typical High $75.86 | Professional | 52 · Reduced service | $37.15 | $50.12 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.95 Typical High $30.20 | Professional | 53 · Discontinued | $14.79 | $19.95 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $74.13 Typical High $112.20 | Professional | 54 · Surgery only | $54.95 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.14 Typical High $22.91 | Professional | 55 · Aftercare only | $11.22 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.00 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.41 | $10.00 | $15.14 |
Where New Hampshire sits
The same service costs 3.5 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· 23rd of 51
$87.10
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.