How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,399 to $5,754Professionalmedian $78 · 10th to 90th $59 to $170
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 (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 26 · Professional part | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | TC · Technical part | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $58.88 | $58.88 | $58.88 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 26 · Professional part | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | TC · Technical part | $34.67 | $34.67 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $81.28 Median $95.50 Typical High $204.17 | Professional | None (both parts) | $81.28 | $95.50 | $204.17 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $35.48 Typical High $77.62 | Professional | 26 · Professional part | $30.90 | $35.48 | $77.62 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $64.57 Typical High $125.89 | Professional | TC · Technical part | $50.12 | $64.57 | $125.89 |
United Setting Professional Modifier None (both parts) Typical Low $91.20 Median $123.03 Typical High $245.47 | Professional | None (both parts) | $91.20 | $123.03 | $245.47 |
United Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $46.77 Typical High $91.20 | Professional | 26 · Professional part | $32.36 | $46.77 | $91.20 |
United Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $77.62 Typical High $154.88 | Professional | TC · Technical part | $58.88 | $77.62 | $154.88 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Facility | None | $3,630.78 | $3,630.78 | $5,754.40 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None (both parts) | $2,511.89 | $2,511.89 | $2,511.89 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 54 · Surgery only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where New Hampshire sits
The same service costs 4.4 times more in Texas than in New York. 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· 27th of 51
$77.62
TX $174NY $39.81
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.