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 $63.10 Median $154.88 Typical High $229.09 | Professional | None | $63.10 | $154.88 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $239.88 | Professional | None | $54.95 | $114.82 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $173.78 Typical High $331.13 | Professional | 50 · Both sides | $114.82 | $173.78 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $194.98 Typical High $457.09 | Professional | None | $83.18 | $194.98 | $457.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $204.17 Typical High $501.19 | Professional | None | $70.79 | $204.17 | $501.19 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
United Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $436.52 | Professional | None | $89.13 | $218.78 | $436.52 |
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 $77.62 Typical High $102.33 | Professional | 52 · Reduced service | $31.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $30.90 Typical High $40.74 | Professional | 53 · Discontinued | $12.59 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $117.49 Typical High $151.36 | Professional | 54 · Surgery only | $46.77 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $23.44 Typical High $30.20 | Professional | 55 · Aftercare only | $9.33 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.31 | $15.49 | $20.42 |
Where New Hampshire sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 32nd of 51
$158
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.