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 $91.20 Median $794.33 Typical High $1,047.13 | Professional | None | $91.20 | $794.33 | $1,047.13 |
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 $81.28 Median $181.97 Typical High $1,778.28 | Professional | None | $81.28 | $181.97 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,659.59 | Facility | None | $537.03 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $346.74 Typical High $2,344.23 | Professional | None | $123.03 | $346.74 | $2,344.23 |
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 $89.13 Median $776.25 Typical High $2,454.71 | Professional | None | $89.13 | $776.25 | $2,454.71 |
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 $89.13 Median $524.81 Typical High $2,041.74 | Professional | None | $89.13 | $524.81 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
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 $45.71 Median $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $45.71 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $18.20 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $69.18 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $13.80 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $79.43 Typical High $104.71 | Professional | 56 · Pre-op care only | $9.12 | $79.43 | $104.71 |
Where New Hampshire sits
The same service costs 14.1 times more in Washington 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· 43rd of 51
$251
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.