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 $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 Typical Low $83.18 Median $354.81 Typical High $645.65 | Professional | None | $83.18 | $354.81 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $338.84 Typical High $977.24 | Professional | None | $104.71 | $338.84 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $1,348.96 | Professional | None | $151.36 | $501.19 | $1,348.96 |
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 $128.82 Median $562.34 Typical High $1,445.44 | Professional | None | $128.82 | $562.34 | $1,445.44 |
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 $169.82 Median $562.34 Typical High $1,288.25 | Professional | None | $169.82 | $562.34 | $1,288.25 |
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 $41.69 Median $177.83 Typical High $295.12 | Professional | 52 · Reduced service | $41.69 | $177.83 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $70.79 Typical High $120.23 | Professional | 53 · Discontinued | $16.60 | $70.79 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $269.15 Typical High $446.68 | Professional | 54 · Surgery only | $61.66 | $269.15 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $53.70 Typical High $89.13 | Professional | 55 · Aftercare only | $12.30 | $53.70 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $35.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $8.32 | $35.48 | $60.26 |
Where New Hampshire sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 38th of 51
$398
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.