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 $123.03 Median $128.82 Typical High $141.25 | Professional | None | $123.03 | $128.82 | $141.25 |
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 $141.25 Median $154.88 Typical High $204.17 | Professional | None | $141.25 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $1,659.59 | Facility | None | $630.96 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $371.54 | Professional | None | $154.88 | $169.82 | $371.54 |
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 $128.82 Median $177.83 Typical High $331.13 | Professional | None | $128.82 | $177.83 | $331.13 |
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 $125.89 Median $165.96 Typical High $331.13 | Professional | None | $125.89 | $165.96 | $331.13 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,365.16 | Facility | None | $3,630.78 | $3,630.78 | $4,365.16 |
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 $61.66 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $97.72 Typical High $104.71 | Professional | 54 · Surgery only | $93.33 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $14.13 |
Where New Hampshire sits
The same service costs 6.0 times more in Alaska 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· 20th 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.