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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $91.20 | Professional | None | $67.61 | $77.62 | $91.20 |
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 $58.88 Median $95.50 Typical High $158.49 | Professional | None | $58.88 | $95.50 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $181.97 Typical High $288.40 | Professional | 50 · Both sides | $138.04 | $181.97 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $154.88 | Facility | None | $77.62 | $107.15 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $245.47 | Professional | None | $95.50 | $131.83 | $245.47 |
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 $69.18 Median $117.49 Typical High $229.09 | Professional | None | $69.18 | $117.49 | $229.09 |
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 $83.18 Median $117.49 Typical High $204.17 | Professional | None | $83.18 | $117.49 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
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 $35.48 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $35.48 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $14.13 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $52.48 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $10.47 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.08 | $7.76 | $9.12 |
Where New Hampshire sits
The same service costs 3.8 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· 16th of 51
$112
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.