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 $275.42 Median $1,380.38 Typical High $9,772.37 | Facility | None | $275.42 | $1,380.38 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $1,000.00 Typical High $1,479.11 | Professional | None | $223.87 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $660.69 Typical High $2,137.96 | Professional | None | $204.17 | $660.69 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $1,000.00 Typical High $3,981.07 | Professional | 50 · Both sides | $562.34 | $1,000.00 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $954.99 Typical High $3,019.95 | Professional | None | $288.40 | $954.99 | $3,019.95 |
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 $251.19 Median $1,258.93 Typical High $3,388.44 | Professional | None | $251.19 | $1,258.93 | $3,388.44 |
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 $323.59 Median $1,318.26 Typical High $3,388.44 | Professional | None | $323.59 | $1,318.26 | $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 $83.18 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $83.18 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $33.11 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $741.31 Typical High $1,071.52 | Professional | 54 · Surgery only | $125.89 | $741.31 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $25.12 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $16.60 | $100.00 | $144.54 |
Where New Hampshire sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$794
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.