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 $70.79 Median $158.49 Typical High $9,772.37 | Facility | None | $70.79 | $158.49 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $158.49 | Professional | None | $60.26 | $93.33 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $44.67 Median $79.43 Typical High $151.36 | Professional | None | $44.67 | $79.43 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $134.90 Typical High $275.42 | Professional | 50 · Both sides | $100.00 | $134.90 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $239.88 | Professional | None | $72.44 | $120.23 | $239.88 |
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 $57.54 Median $107.15 Typical High $251.19 | Professional | None | $57.54 | $107.15 | $251.19 |
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 $69.18 Median $107.15 Typical High $234.42 | Professional | None | $69.18 | $107.15 | $234.42 |
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 $35.48 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $35.48 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $14.13 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $53.70 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $10.72 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.08 | $12.30 | $15.85 |
Where New Hampshire sits
The same service costs 3.2 times more in Wisconsin 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· 23rd of 51
$100
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.