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 $363.08 Median $2,398.83 Typical High $9,772.37 | Facility | None | $363.08 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $1,380.38 Typical High $2,398.83 | Professional | None | $302.00 | $1,380.38 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $954.99 Typical High $3,548.13 | Professional | None | $295.12 | $954.99 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,348.96 Typical High $4,466.84 | Professional | None | $398.11 | $1,348.96 | $4,466.84 |
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 $363.08 Median $1,819.70 Typical High $5,248.07 | Professional | None | $363.08 | $1,819.70 | $5,248.07 |
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 $446.68 Median $1,819.70 Typical High $5,011.87 | Professional | None | $446.68 | $1,819.70 | $5,011.87 |
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 $107.15 Median $691.83 Typical High $1,174.90 | Professional | 52 · Reduced service | $107.15 | $691.83 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $275.42 Typical High $478.63 | Professional | 53 · Discontinued | $42.66 | $275.42 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $1,023.29 Typical High $1,778.28 | Professional | 54 · Surgery only | $158.49 | $1,023.29 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $204.17 Typical High $354.81 | Professional | 55 · Aftercare only | $31.62 | $204.17 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $138.04 Typical High $239.88 | Professional | 56 · Pre-op care only | $21.38 | $138.04 | $239.88 |
Where New Hampshire sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 39th of 51
$1,122
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.