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 $154.88 Median $416.87 Typical High $1,202.26 | Professional | None | $154.88 | $416.87 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $467.74 Typical High $1,230.27 | Professional | None | $147.91 | $467.74 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,071.52 Typical High $1,348.96 | Facility | None | $630.96 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $645.65 Typical High $1,698.24 | Professional | None | $213.80 | $645.65 | $1,698.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $724.44 Typical High $1,949.84 | Professional | None | $177.83 | $724.44 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $223.87 Median $707.95 Typical High $1,584.89 | Professional | None | $223.87 | $707.95 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
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 $48.98 Median $208.93 Typical High $331.13 | Professional | 52 · Reduced service | $48.98 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $83.18 Typical High $131.83 | Professional | 53 · Discontinued | $19.95 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $309.03 Typical High $489.78 | Professional | 54 · Surgery only | $74.13 | $309.03 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $14.79 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $9.77 | $41.69 | $66.07 |
Where New Hampshire sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 19th of 51
$661
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.