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 $54.95 Median $93.33 Typical High $134.90 | Professional | None | $54.95 | $93.33 | $134.90 |
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 $54.95 Median $109.65 Typical High $154.88 | Professional | None | $54.95 | $109.65 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $575.44 | Facility | None | $125.89 | $165.96 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $316.23 | Professional | None | $85.11 | $154.88 | $316.23 |
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 $151.36 Typical High $354.81 | Professional | None | $69.18 | $151.36 | $354.81 |
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 $79.43 Median $147.91 Typical High $295.12 | Professional | None | $79.43 | $147.91 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
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 $26.92 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $26.92 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $10.96 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $69.18 Typical High $77.62 | Professional | 54 · Surgery only | $40.74 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $8.13 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.37 | $9.33 | $10.23 |
Where New Hampshire sits
The same service costs 3.9 times more in Wisconsin 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· 25th of 51
$117
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.