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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $186.21 | Professional | None | $57.54 | $102.33 | $186.21 |
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 $48.98 Median $120.23 Typical High $204.17 | Professional | None | $48.98 | $120.23 | $204.17 |
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 $64.57 Median $151.36 Typical High $346.74 | Professional | None | $64.57 | $151.36 | $346.74 |
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 $75.86 Median $162.18 Typical High $416.87 | Professional | None | $75.86 | $162.18 | $416.87 |
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 $79.43 Median $144.54 Typical High $331.13 | Professional | None | $79.43 | $144.54 | $331.13 |
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 $28.84 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $28.84 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $20.42 Typical High $26.92 | Professional | 53 · Discontinued | $11.48 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $75.86 Typical High $102.33 | Professional | 54 · Surgery only | $42.66 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $8.51 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.75 | $10.23 | $13.49 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 17th of 51
$135
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.