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 $2,398.83 Median $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $354.81 | Professional | None | $169.82 | $263.03 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $407.38 | Professional | None | $107.15 | $229.09 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $338.84 Typical High $691.83 | Professional | 50 · Both sides | $239.88 | $338.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $1,174.90 | Facility | None | $223.87 | $295.12 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $676.08 | Professional | None | $173.78 | $316.23 | $676.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $741.31 | Professional | None | $141.25 | $295.12 | $741.31 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $645.65 | Professional | None | $169.82 | $288.40 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
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 $114.82 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $114.82 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $34.67 |
Where New Hampshire sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 31st of 51
$263
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.