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 $93.33 Median $125.89 Typical High $234.42 | Professional | None | $93.33 | $125.89 | $234.42 |
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 $81.28 Median $138.04 Typical High $251.19 | Professional | None | $81.28 | $138.04 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $575.44 | Facility | None | $114.82 | $151.36 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $380.19 | Professional | None | $134.90 | $213.80 | $380.19 |
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 $104.71 Median $181.97 Typical High $436.52 | Professional | None | $104.71 | $181.97 | $436.52 |
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 $123.03 Median $173.78 Typical High $302.00 | Professional | None | $123.03 | $173.78 | $302.00 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
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 $48.98 Median $60.26 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $19.50 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $91.20 Typical High $95.50 | Professional | 54 · Surgery only | $72.44 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.02 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $12.02 | $12.59 |
Where New Hampshire sits
The same service costs 3.3 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· 17th of 51
$166
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.