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 $58.88 Median $147.91 Typical High $194.98 | Professional | None | $58.88 | $147.91 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $91.20 Typical High $269.15 | Professional | None | $43.65 | $91.20 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | 50 · Both sides | $104.71 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $2,691.53 | Facility | None | $489.78 | $489.78 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $524.81 | Professional | None | $74.13 | $208.93 | $524.81 |
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 $52.48 Median $208.93 Typical High $478.63 | Professional | None | $52.48 | $208.93 | $478.63 |
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 $186.21 Typical High $426.58 | Professional | None | $64.57 | $186.21 | $426.58 |
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 $30.20 Median $74.13 Typical High $97.72 | Professional | 52 · Reduced service | $30.20 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $12.30 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $45.71 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $9.12 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.03 | $15.85 | $19.50 |
Where New Hampshire sits
The same service costs 4.6 times more in Iowa 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· 40th of 51
$110
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.