How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | None | $102.33 | $109.65 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $489.78 Typical High $2,290.87 | Facility | None | $199.53 | $489.78 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $245.47 | Professional | None | $114.82 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $288.40 | Professional | None | $131.83 | $194.98 | $288.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,884.03 | Facility | None | $776.25 | $851.14 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $288.40 | Professional | None | $104.71 | $147.91 | $288.40 |
United Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,884.03 | Facility | None | $776.25 | $933.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $295.12 | Professional | None | $112.20 | $147.91 | $295.12 |
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 $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $75.86 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $12.02 |
Where New Hampshire sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 15th of 51
$170
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.