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 $128.82 Median $169.82 Typical High $309.03 | Professional | None | $128.82 | $169.82 | $309.03 |
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 $107.15 Median $190.55 Typical High $331.13 | Professional | None | $107.15 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $575.44 | Facility | None | $147.91 | $194.98 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $512.86 | Professional | None | $154.88 | $288.40 | $512.86 |
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 $141.25 Median $245.47 Typical High $588.84 | Professional | None | $141.25 | $245.47 | $588.84 |
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 $165.96 Median $234.42 Typical High $407.38 | Professional | None | $165.96 | $234.42 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
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 $66.07 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $125.89 | Professional | 54 · Surgery only | $100.00 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $16.98 |
Where New Hampshire sits
The same service costs 3.7 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· 20th of 51
$224
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.