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 $134.90 Median $173.78 Typical High $239.88 | Professional | None | $134.90 | $173.78 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
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 $102.33 Median $194.98 Typical High $239.88 | Professional | None | $102.33 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $630.96 | Facility | None | $165.96 | $229.09 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $467.74 | Professional | None | $162.18 | $269.15 | $467.74 |
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 $123.03 Median $229.09 Typical High $457.09 | Professional | None | $123.03 | $229.09 | $457.09 |
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 $147.91 Median $234.42 Typical High $398.11 | Professional | None | $147.91 | $234.42 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
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 $77.62 Median $87.10 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $23.99 |
Where New Hampshire sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 16th of 51
$209
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.