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 $204.17 Median $812.83 Typical High $1,318.26 | Professional | None | $204.17 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $602.56 Typical High $1,905.46 | Professional | None | $186.21 | $602.56 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $870.96 Typical High $2,570.40 | Professional | None | $263.03 | $870.96 | $2,570.40 |
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 $229.09 Median $1,096.48 Typical High $2,951.21 | Professional | None | $229.09 | $1,096.48 | $2,951.21 |
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 $288.40 Median $1,096.48 Typical High $2,951.21 | Professional | None | $288.40 | $1,096.48 | $2,951.21 |
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 $77.62 Median $407.38 Typical High $660.69 | Professional | 52 · Reduced service | $77.62 | $407.38 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $162.18 Typical High $263.03 | Professional | 53 · Discontinued | $30.90 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $616.60 Typical High $977.24 | Professional | 54 · Surgery only | $117.49 | $616.60 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $123.03 Typical High $199.53 | Professional | 55 · Aftercare only | $23.44 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $81.28 Typical High $131.83 | Professional | 56 · Pre-op care only | $15.49 | $81.28 | $131.83 |
Where New Hampshire sits
The same service costs 4.1 times more in Washington than in Nebraska. 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· 40th of 51
$741
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.