How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,399 to $5,754Professionalmedian $55 · 10th to 90th $38 to $120
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 $52.48 Median $52.48 Typical High $52.48 | Professional | None (both parts) | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 26 · Professional part | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | TC · Technical part | $33.11 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 26 · Professional part | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | TC · Technical part | $35.48 | $35.48 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $38.02 Median $61.66 Typical High $141.25 | Professional | None (both parts) | $38.02 | $61.66 | $141.25 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $26.92 Typical High $58.88 | Professional | 26 · Professional part | $23.99 | $26.92 | $58.88 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $63.10 Typical High $107.15 | Professional | TC · Technical part | $39.81 | $63.10 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $61.66 Median $85.11 Typical High $165.96 | Professional | None (both parts) | $61.66 | $85.11 | $165.96 |
United Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $31.62 Typical High $61.66 | Professional | 26 · Professional part | $21.88 | $31.62 | $61.66 |
United Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $53.70 Typical High $104.71 | Professional | TC · Technical part | $39.81 | $53.70 | $104.71 |
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 $26.30 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 54 · Surgery only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where New Hampshire sits
The same service costs 3.3 times more in Nebraska 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· 30th of 51
$54.95
NE $112NY $33.88
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.