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 $57.54 Median $75.86 Typical High $87.10 | Professional | None | $57.54 | $75.86 | $87.10 |
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 $46.77 Median $85.11 Typical High $104.71 | Professional | None | $46.77 | $85.11 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $144.54 Typical High $199.53 | Professional | 50 · Both sides | $93.33 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $151.36 | Facility | None | $85.11 | $117.49 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $208.93 | Professional | None | $70.79 | $120.23 | $208.93 |
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 $53.70 Median $97.72 Typical High $194.98 | Professional | None | $53.70 | $97.72 | $194.98 |
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 $58.88 Median $102.33 Typical High $181.97 | Professional | None | $58.88 | $102.33 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
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 $28.84 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $28.84 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.13 Typical High $17.38 | Professional | 53 · Discontinued | $11.48 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $53.70 Typical High $64.57 | Professional | 54 · Surgery only | $43.65 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.75 | $7.08 | $8.71 |
Where New Hampshire sits
The same service costs 3.6 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· 20th of 51
$87.10
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.