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 $67.61 Median $120.23 Typical High $218.78 | Professional | None | $67.61 | $120.23 | $218.78 |
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 $57.54 Median $144.54 Typical High $245.47 | Professional | None | $57.54 | $144.54 | $245.47 |
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 $75.86 Median $169.82 Typical High $380.19 | Professional | None | $75.86 | $169.82 | $380.19 |
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 $89.13 Median $190.55 Typical High $457.09 | Professional | None | $89.13 | $190.55 | $457.09 |
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 $93.33 Median $169.82 Typical High $363.08 | Professional | None | $93.33 | $169.82 | $363.08 |
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 $33.88 Median $60.26 Typical High $74.13 | Professional | 52 · Reduced service | $33.88 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $13.49 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $50.12 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $10.00 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.02 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.76 | $12.02 | $14.79 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 16th of 51
$151
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.