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 $61.66 Median $95.50 Typical High $173.78 | Professional | None | $61.66 | $95.50 | $173.78 |
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 $48.98 Median $95.50 Typical High $169.82 | Professional | None | $48.98 | $95.50 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $575.44 | Facility | None | $77.62 | $102.33 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $239.88 | Professional | None | $85.11 | $138.04 | $239.88 |
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 $66.07 Median $123.03 Typical High $295.12 | Professional | None | $66.07 | $123.03 | $295.12 |
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 $79.43 Median $123.03 Typical High $218.78 | Professional | None | $79.43 | $123.03 | $218.78 |
Well Sense Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
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 $31.62 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $31.62 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $12.59 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $66.07 Typical High $70.79 | Professional | 54 · Surgery only | $47.86 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $9.55 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.31 | $8.91 | $9.55 |
Where New Hampshire sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 21st of 51
$110
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.