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 $87.10 Median $295.12 Typical High $8,912.51 | Facility | None | $87.10 | $295.12 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $331.13 | Professional | None | $69.18 | $154.88 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $125.89 Typical High $239.88 | Professional | None | $61.66 | $125.89 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $190.55 Typical High $363.08 | Professional | 50 · Both sides | $125.89 | $190.55 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $467.74 | Professional | None | $91.20 | $213.80 | $467.74 |
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 $77.62 Median $204.17 Typical High $501.19 | Professional | None | $77.62 | $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 $95.50 Median $223.87 Typical High $467.74 | Professional | None | $95.50 | $223.87 | $467.74 |
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 $34.67 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $34.67 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $13.80 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $117.49 Typical High $158.49 | Professional | 54 · Surgery only | $51.29 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.44 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.92 | $15.49 | $21.38 |
Where New Hampshire sits
The same service costs 3.8 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· 30th of 51
$174
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.