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 $58.88 Median $102.33 Typical High $190.55 | Professional | None | $58.88 | $102.33 | $190.55 |
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 $51.29 Median $117.49 Typical High $208.93 | Professional | None | $51.29 | $117.49 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $213.80 | Facility | None | $100.00 | $169.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $151.36 Typical High $346.74 | Professional | None | $66.07 | $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 $81.28 Median $169.82 Typical High $416.87 | Professional | None | $81.28 | $169.82 | $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 $83.18 Median $151.36 Typical High $338.84 | Professional | None | $83.18 | $151.36 | $338.84 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $29.51 Median $51.29 Typical High $69.18 | Professional | 52 · Reduced service | $29.51 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $11.75 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $44.67 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.49 Typical High $20.89 | Professional | 55 · Aftercare only | $8.91 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.89 | $10.23 | $13.80 |
Where New Hampshire sits
The same service costs 3.1 times more in Alaska 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· 14th 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.