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 $33.11 Median $95.50 Typical High $125.89 | Professional | None | $33.11 | $95.50 | $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 $29.51 Median $70.79 Typical High $141.25 | Professional | None | $29.51 | $70.79 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $213.80 | Facility | None | $100.00 | $169.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $125.89 Typical High $281.84 | Professional | None | $42.66 | $125.89 | $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 $37.15 Median $112.20 Typical High $323.59 | Professional | None | $37.15 | $112.20 | $323.59 |
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 $41.69 Median $112.20 Typical High $229.09 | Professional | None | $41.69 | $112.20 | $229.09 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $16.60 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $16.60 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $6.61 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $74.13 Typical High $85.11 | Professional | 54 · Surgery only | $25.12 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $5.01 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.31 | $10.00 | $11.48 |
Where New Hampshire sits
The same service costs 5.4 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· 25th of 51
$105
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.