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 $30.20 Median $40.74 Typical High $75.86 | Professional | None | $30.20 | $40.74 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $46.77 Typical High $72.44 | Professional | None | $25.12 | $46.77 | $72.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $23.44 Median $36.31 Typical High $50.12 | Professional | 62 · Two surgeons | $23.44 | $36.31 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $537.03 Typical High $2,691.53 | Facility | None | $489.78 | $537.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $112.20 | Professional | None | $43.65 | $64.57 | $112.20 |
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 $33.11 Median $56.23 Typical High $117.49 | Professional | None | $33.11 | $56.23 | $117.49 |
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 $39.81 Median $52.48 Typical High $97.72 | Professional | None | $39.81 | $52.48 | $97.72 |
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 $15.85 Median $19.50 Typical High $20.42 | Professional | 52 · Reduced service | $15.85 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.76 Typical High $8.13 | Professional | 53 · Discontinued | $6.31 | $7.76 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $28.84 Typical High $30.90 | Professional | 54 · Surgery only | $23.99 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.75 Typical High $6.17 | Professional | 55 · Aftercare only | $4.79 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.89 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.16 | $3.89 | $4.07 |
Where New Hampshire sits
The same service costs 3.3 times more in Alaska 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· 27th of 51
$48.98
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.