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 $125.89 Median $213.80 Typical High $281.84 | Professional | None | $125.89 | $213.80 | $281.84 |
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 $117.49 Median $275.42 Typical High $446.68 | Professional | None | $117.49 | $275.42 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $407.38 Typical High $870.96 | Professional | 50 · Both sides | $275.42 | $407.38 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $426.58 Typical High $724.44 | Facility | None | $323.59 | $426.58 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $724.44 | Professional | None | $190.55 | $380.19 | $724.44 |
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 $151.36 Median $354.81 Typical High $870.96 | Professional | None | $151.36 | $354.81 | $870.96 |
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 $181.97 Median $354.81 Typical High $691.83 | Professional | None | $181.97 | $354.81 | $691.83 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
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 $63.10 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $25.12 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $93.33 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $21.38 | $24.55 |
Where New Hampshire sits
The same service costs 3.2 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
$282
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.