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 $67.61 Median $128.82 Typical High $141.25 | Professional | None | $67.61 | $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 $61.66 Median $138.04 Typical High $316.23 | Professional | None | $61.66 | $138.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $630.96 | Facility | None | $223.87 | $295.12 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $407.38 | Professional | None | $104.71 | $204.17 | $407.38 |
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 $72.44 Median $181.97 Typical High $416.87 | Professional | None | $72.44 | $181.97 | $416.87 |
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 $74.13 Median $162.18 Typical High $323.59 | Professional | None | $74.13 | $162.18 | $323.59 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $33.88 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $33.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $13.49 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $97.72 Typical High $100.00 | Professional | 54 · Surgery only | $50.12 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $13.18 | $13.18 |
Where New Hampshire sits
The same service costs 3.7 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· 22nd of 51
$151
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.