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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $263.03 | Professional | None | $158.49 | $199.53 | $263.03 |
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 $114.82 Median $190.55 Typical High $257.04 | Professional | None | $114.82 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $199.53 Typical High $630.96 | Facility | None | $147.91 | $199.53 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $478.63 | Professional | None | $181.97 | $288.40 | $478.63 |
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 $138.04 Median $245.47 Typical High $457.09 | Professional | None | $138.04 | $245.47 | $457.09 |
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 $169.82 Median $245.47 Typical High $416.87 | Professional | None | $169.82 | $245.47 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
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 $81.28 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $33.11 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $151.36 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $26.30 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | GC · Resident with teaching physician | $380.19 | $380.19 | $380.19 |
Where New Hampshire sits
The same service costs 3.6 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· 16th of 51
$224
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.