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 $141.25 Median $1,819.70 Typical High $9,772.37 | Facility | None | $141.25 | $1,819.70 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | None | $120.23 | $141.25 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | None | $162.18 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $7,079.46 | Facility | None | $489.78 | $630.96 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $346.74 | Professional | None | $154.88 | $173.78 | $346.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $549.54 Typical High $2,630.27 | Facility | None | $323.59 | $549.54 | $2,630.27 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $323.59 | Professional | None | $128.82 | $181.97 | $323.59 |
United Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $2,630.27 | Facility | None | $323.59 | $537.03 | $2,630.27 |
United Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $323.59 | Professional | None | $125.89 | $165.96 | $323.59 |
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 $61.66 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $14.13 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 15th of 51
$191
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.