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 $194.98 Median $346.74 Typical High $467.74 | Professional | None | $194.98 | $346.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $10,715.19 Typical High $19,952.62 | Facility | None | $9,332.54 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $758.58 | Professional | None | $239.88 | $426.58 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $295.12 Typical High $575.44 | Professional | 62 · Two surgeons | $218.78 | $295.12 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $3,981.07 Typical High $5,495.41 | Facility | None | $575.44 | $3,981.07 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $1,202.26 | Professional | None | $331.13 | $660.69 | $1,202.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $3,630.78 | Facility | None | $660.69 | $776.25 | $3,630.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $1,288.25 | Professional | None | $316.23 | $575.44 | $1,288.25 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $3,630.78 | Facility | None | $660.69 | $851.14 | $3,630.78 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $933.25 | Professional | None | $389.05 | $549.54 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $97.72 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $97.72 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $38.90 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $147.91 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $29.51 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $36.31 | $36.31 |
Where New Hampshire sits
The same service costs 3.9 times more in Alaska than in New York. 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· 22nd of 51
$501
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.