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 $66.07 Median $112.20 Typical High $186.21 | Professional | None | $66.07 | $112.20 | $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 $60.26 Median $144.54 Typical High $257.04 | Professional | None | $60.26 | $144.54 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $251.19 | Facility | None | $100.00 | $199.53 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $398.11 | Professional | None | $79.43 | $173.78 | $398.11 |
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 $93.33 Median $194.98 Typical High $467.74 | Professional | None | $93.33 | $194.98 | $467.74 |
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 $177.83 Typical High $371.54 | Professional | None | $93.33 | $177.83 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $33.11 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $33.11 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $13.18 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $50.12 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $10.00 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.61 | $11.22 | $15.14 |
Where New Hampshire sits
The same service costs 3.2 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
$158
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.