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 $138.04 Median $223.87 Typical High $9,772.37 | Facility | None | $138.04 | $223.87 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $223.87 | Professional | None | $107.15 | $144.54 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $269.15 | Professional | None | $74.13 | $144.54 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $870.96 | Facility | None | $436.52 | $588.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $407.38 | Professional | None | $102.33 | $194.98 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $446.68 | Professional | None | $95.50 | $186.21 | $446.68 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $389.05 | Professional | None | $107.15 | $181.97 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $69.18 Median $69.18 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $69.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $169.82 | Professional | 54 · Surgery only | $102.33 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $22.39 |
Where New Hampshire sits
The same service costs 3.6 times more in Wisconsin 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· 24th of 51
$174
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.