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 $104.71 Median $114.82 Typical High $165.96 | Professional | None | $104.71 | $114.82 | $165.96 |
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 $63.10 Median $165.96 Typical High $281.84 | Professional | None | $63.10 | $165.96 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $575.44 | Facility | None | $177.83 | $234.42 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $467.74 | Professional | None | $91.20 | $208.93 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $524.81 | Professional | None | $83.18 | $190.55 | $524.81 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $416.87 | Professional | None | $97.72 | $181.97 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $52.48 Median $57.54 Typical High $83.18 | Professional | 52 · Reduced service | $52.48 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $33.11 | Professional | 53 · Discontinued | $20.89 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $87.10 Typical High $125.89 | Professional | 54 · Surgery only | $77.62 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $16.60 |
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· 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.