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 $190.55 Median $912.01 Typical High $1,348.96 | Professional | None | $190.55 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $724.44 Typical High $2,754.23 | Professional | None | $218.78 | $724.44 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $1,071.52 Typical High $4,570.88 | Professional | 50 · Both sides | $602.56 | $1,071.52 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,023.29 Typical High $3,162.28 | Professional | None | $316.23 | $1,023.29 | $3,162.28 |
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 $269.15 Median $1,348.96 Typical High $4,073.80 | Professional | None | $269.15 | $1,348.96 | $4,073.80 |
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 $331.13 Median $1,348.96 Typical High $3,388.44 | Professional | None | $331.13 | $1,348.96 | $3,388.44 |
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 $457.09 Typical High $676.08 | Professional | 52 · Reduced service | $77.62 | $457.09 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $181.97 Typical High $269.15 | Professional | 53 · Discontinued | $30.90 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $691.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $114.82 | $691.83 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $138.04 Typical High $204.17 | Professional | 55 · Aftercare only | $22.91 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $15.49 | $91.20 | $134.90 |
Where New Hampshire sits
The same service costs 6.5 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
$912
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.