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 $16.98 Median $34.67 Typical High $57.54 | Facility | None | $16.98 | $34.67 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $33.11 Typical High $44.67 | Professional | None | $16.98 | $33.11 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $5,495.41 Typical High $8,709.64 | Facility | None | $4,897.79 | $5,495.41 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $29.51 Typical High $63.10 | Professional | None | $13.18 | $29.51 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $41.69 Typical High $83.18 | Professional | None | $19.05 | $41.69 | $83.18 |
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 $21.38 Median $43.65 Typical High $97.72 | Professional | None | $21.38 | $43.65 | $97.72 |
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 $21.38 Median $41.69 Typical High $87.10 | Professional | None | $21.38 | $41.69 | $87.10 |
Well Sense Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
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 $8.51 Median $16.98 Typical High $21.88 | Professional | 52 · Reduced service | $8.51 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $6.92 Typical High $8.91 | Professional | 53 · Discontinued | $3.39 | $6.92 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $25.70 Typical High $33.11 | Professional | 54 · Surgery only | $12.59 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $5.13 Typical High $6.61 | Professional | 55 · Aftercare only | $2.51 | $5.13 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $3.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.70 | $3.47 | $4.47 |
Where New Hampshire sits
The same service costs 3.5 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· 26th of 51
$34.67
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.