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 $43.65 Median $58.88 Typical High $77.62 | Professional | None | $43.65 | $58.88 | $77.62 |
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 $44.67 Median $89.13 Typical High $158.49 | Professional | None | $44.67 | $89.13 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $141.25 | Facility | None | $79.43 | $107.15 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $218.78 | Professional | None | $56.23 | $112.20 | $218.78 |
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 $66.07 Median $117.49 Typical High $275.42 | Professional | None | $66.07 | $117.49 | $275.42 |
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 $64.57 Median $109.65 Typical High $199.53 | Professional | None | $64.57 | $109.65 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
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 $21.88 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $21.88 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $8.71 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $44.67 Typical High $58.88 | Professional | 54 · Surgery only | $33.11 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $6.61 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.37 | $5.89 | $7.76 |
Where New Hampshire sits
The same service costs 3.4 times more in Alaska than in New York. 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· 11th of 51
$105
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.