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 $371.54 Median $1,949.84 Typical High $11,481.54 | Facility | None | $371.54 | $1,949.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,380.38 Typical High $2,137.96 | Professional | None | $346.74 | $1,380.38 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $1,071.52 Typical High $4,265.80 | Professional | None | $323.59 | $1,071.52 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,584.89 Typical High $7,079.46 | Professional | 50 · Both sides | $891.25 | $1,584.89 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,513.56 Typical High $4,897.79 | Professional | None | $436.52 | $1,513.56 | $4,897.79 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $2,137.96 Typical High $6,606.93 | Professional | None | $407.38 | $2,137.96 | $6,606.93 |
United Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
United Setting Professional Modifier None Typical Low $489.78 Median $2,137.96 Typical High $4,897.79 | Professional | None | $489.78 | $2,137.96 | $4,897.79 |
6 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 $120.23 Median $691.83 Typical High $977.24 | Professional | 52 · Reduced service | $120.23 | $691.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $275.42 Typical High $389.05 | Professional | 53 · Discontinued | $47.86 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $1,023.29 Typical High $1,445.44 | Professional | 54 · Surgery only | $177.83 | $1,023.29 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $204.17 Typical High $288.40 | Professional | 55 · Aftercare only | $35.48 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $138.04 Typical High $194.98 | Professional | 56 · Pre-op care only | $23.99 | $138.04 | $194.98 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $1,621.81 | $1,621.81 | $1,621.81 |
Where New Hampshire sits
The same service costs 6.3 times more in Washington 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· 42nd of 51
$1,413
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.