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 $93.33 Median $144.54 Typical High $208.93 | Professional | None | $93.33 | $144.54 | $208.93 |
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 $77.62 Median $128.82 Typical High $245.47 | Professional | None | $77.62 | $128.82 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $204.17 Typical High $489.78 | Professional | 50 · Both sides | $141.25 | $204.17 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $177.83 | Facility | None | $100.00 | $141.25 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $354.81 | Professional | None | $107.15 | $173.78 | $354.81 |
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 $100.00 Median $177.83 Typical High $407.38 | Professional | None | $100.00 | $177.83 | $407.38 |
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 $114.82 Median $162.18 Typical High $363.08 | Professional | None | $114.82 | $162.18 | $363.08 |
Well Sense Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
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 $72.44 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $72.44 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $20.89 |
Where New Hampshire sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 20th 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.