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 $72.44 Median $123.03 Typical High $123.03 | Professional | None | $72.44 | $123.03 | $123.03 |
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 $109.65 Median $186.21 Typical High $229.09 | Professional | None | $109.65 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $1,659.59 | Facility | None | $489.78 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $281.84 | Professional | None | $125.89 | $177.83 | $281.84 |
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 $91.20 Median $138.04 Typical High $275.42 | Professional | None | $91.20 | $138.04 | $275.42 |
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 $107.15 Median $144.54 Typical High $275.42 | Professional | None | $107.15 | $144.54 | $275.42 |
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 $36.31 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $36.31 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $12.30 | $12.30 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 17th of 51
$158
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.