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 $75.86 Median $234.42 Typical High $295.12 | Professional | None | $75.86 | $234.42 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $416.87 | Professional | None | $69.18 | $144.54 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $218.78 Typical High $407.38 | Professional | 50 · Both sides | $141.25 | $218.78 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $251.19 Typical High $758.58 | Professional | None | $104.71 | $251.19 | $758.58 |
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 $87.10 Median $302.00 Typical High $851.14 | Professional | None | $87.10 | $302.00 | $851.14 |
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 $109.65 Median $309.03 Typical High $676.08 | Professional | None | $109.65 | $309.03 | $676.08 |
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 $38.02 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $38.02 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $15.14 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $56.23 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $11.22 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.59 | $23.44 | $28.18 |
Where New Hampshire sits
The same service costs 4.2 times more in Washington 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· 37th of 51
$209
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.