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 $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 $229.09 Median $295.12 Typical High $416.87 | Professional | None | $229.09 | $295.12 | $416.87 |
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 $173.78 Median $354.81 Typical High $660.69 | Professional | None | $173.78 | $354.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $870.96 | Facility | None | $467.74 | $602.56 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $1,000.00 | Professional | None | $245.47 | $446.68 | $1,000.00 |
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 $223.87 Median $446.68 Typical High $1,071.52 | Professional | None | $223.87 | $446.68 | $1,071.52 |
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 $269.15 Median $436.52 Typical High $954.99 | Professional | None | $269.15 | $436.52 | $954.99 |
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 $141.25 Median $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $83.18 | Professional | 53 · Discontinued | $56.23 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $41.69 |
Where New Hampshire sits
The same service costs 3.0 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· 21st of 51
$407
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.