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 $194.98 Typical High $8,912.51 | Facility | None | $112.20 | $194.98 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $275.42 | Professional | None | $112.20 | $134.90 | $275.42 |
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 $77.62 Median $120.23 Typical High $239.88 | Professional | None | $77.62 | $120.23 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $223.87 Typical High $398.11 | Professional | 50 · Both sides | $151.36 | $223.87 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $128.82 Typical High $575.44 | Facility | None | $97.72 | $128.82 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $288.40 | Professional | None | $109.65 | $173.78 | $288.40 |
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 $125.89 Median $190.55 Typical High $380.19 | Professional | None | $125.89 | $190.55 | $380.19 |
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 $128.82 Median $173.78 Typical High $302.00 | Professional | None | $128.82 | $173.78 | $302.00 |
Well Sense Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
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 $56.23 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $22.39 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | 54 · Surgery only | $83.18 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $15.49 |
Where New Hampshire sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$148
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.