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 $331.13 Median $1,479.11 Typical High $2,511.89 | Professional | None | $331.13 | $1,479.11 | $2,511.89 |
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 $302.00 Median $977.24 Typical High $3,388.44 | Professional | None | $302.00 | $977.24 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,445.44 Typical High $5,370.32 | Professional | None | $426.58 | $1,445.44 | $5,370.32 |
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 $371.54 Median $1,995.26 Typical High $5,888.44 | Professional | None | $371.54 | $1,995.26 | $5,888.44 |
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 $2,290.87 Typical High $5,754.40 | Professional | None | $489.78 | $2,290.87 | $5,754.40 |
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 $125.89 Median $831.76 Typical High $1,258.93 | Professional | 52 · Reduced service | $125.89 | $831.76 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $331.13 Typical High $512.86 | Professional | 53 · Discontinued | $50.12 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $1,230.27 Typical High $1,905.46 | Professional | 54 · Surgery only | $190.55 | $1,230.27 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $245.47 Typical High $380.19 | Professional | 55 · Aftercare only | $38.02 | $245.47 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $165.96 Typical High $251.19 | Professional | 56 · Pre-op care only | $25.12 | $165.96 | $251.19 |
Where New Hampshire sits
The same service costs 6.9 times more in Wisconsin 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· 42nd of 51
$1,445
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.