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 $186.21 Median $208.93 Typical High $331.13 | Professional | None | $186.21 | $208.93 | $331.13 |
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 $154.88 Median $316.23 Typical High $407.38 | Professional | None | $154.88 | $316.23 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $295.12 Typical High $371.54 | Facility | None | $100.00 | $295.12 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $707.95 | Professional | None | $229.09 | $398.11 | $707.95 |
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 $181.97 Median $346.74 Typical High $758.58 | Professional | None | $181.97 | $346.74 | $758.58 |
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 $208.93 Median $331.13 Typical High $562.34 | Professional | None | $208.93 | $331.13 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
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 $95.50 Median $104.71 Typical High $165.96 | Professional | 52 · Reduced service | $95.50 | $104.71 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $66.07 | Professional | 53 · Discontinued | $38.02 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $48.98 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.05 | $20.89 | $33.11 |
Where New Hampshire sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 13th of 51
$316
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.