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 $64.57 Median $107.15 Typical High $125.89 | Professional | None | $64.57 | $107.15 | $125.89 |
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 $123.03 Median $186.21 Typical High $251.19 | Professional | None | $123.03 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $676.08 | Facility | None | $371.54 | $489.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $288.40 | Professional | None | $125.89 | $199.53 | $288.40 |
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 $97.72 Median $147.91 Typical High $257.04 | Professional | None | $97.72 | $147.91 | $257.04 |
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 $114.82 Median $147.91 Typical High $257.04 | Professional | None | $114.82 | $147.91 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
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 $32.36 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $32.36 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $12.88 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $47.86 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.46 | $10.72 | $12.59 |
Where New Hampshire sits
The same service costs 4.8 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· 15th of 51
$166
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.