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 Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | None | $125.89 | $125.89 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $338.84 | Facility | None | $177.83 | $245.47 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $295.12 | Professional | None | $125.89 | $181.97 | $295.12 |
United Setting Professional Modifier None Typical Low $16.22 Median $125.89 Typical High $131.83 | Professional | None | $16.22 | $125.89 | $131.83 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where New Hampshire sits
The same service costs 3.6 times more in Wyoming than in North Carolina. 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· 40th of 51
$126
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.