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 $102.33 Median $218.78 Typical High $229.09 | Professional | None | $102.33 | $218.78 | $229.09 |
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 $95.50 Median $213.80 Typical High $407.38 | Professional | None | $95.50 | $213.80 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $3,467.37 | Facility | None | $537.03 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $512.86 | Professional | None | $147.91 | $281.84 | $512.86 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $104.71 Median $251.19 Typical High $549.54 | Professional | None | $104.71 | $251.19 | $549.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $407.38 | Professional | None | $102.33 | $213.80 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
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 $51.29 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $51.29 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $20.42 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $77.62 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $32.36 Typical High $34.67 | Professional | 55 · Aftercare only | $15.49 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.23 | $21.38 | $22.91 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Washington, DC. 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
$219
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.