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 $281.84 Median $2,398.83 Typical High $9,772.37 | Facility | None | $281.84 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $602.56 Typical High $5,370.32 | Professional | None | $234.42 | $602.56 | $5,370.32 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $549.54 Typical High $3,981.07 | Professional | None | $204.17 | $549.54 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,585.78 Typical High $10,471.29 | Facility | None | $630.96 | $7,585.78 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $1,023.29 Typical High $8,128.31 | Professional | None | $288.40 | $1,023.29 | $8,128.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $2,951.21 Typical High $8,912.51 | Professional | None | $269.15 | $2,951.21 | $8,912.51 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,318.26 Typical High $8,128.31 | Professional | None | $338.84 | $1,318.26 | $8,128.31 |
Well Sense Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $138.04 Median $138.04 Typical High $1,862.09 | Professional | 52 · Reduced service | $138.04 | $138.04 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $758.58 | Professional | 53 · Discontinued | $56.23 | $56.23 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $2,818.38 | Professional | 54 · Surgery only | $208.93 | $208.93 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $562.34 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $371.54 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $371.54 |
Where New Hampshire sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 48th of 51
$1,318
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.