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 $83.18 Median $131.83 Typical High $154.88 | Professional | None | $83.18 | $131.83 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $346.74 | Professional | None | $141.25 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $676.08 | Facility | None | $371.54 | $478.63 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $331.13 | Professional | None | $158.49 | $223.87 | $331.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $331.13 | Professional | None | $125.89 | $186.21 | $331.13 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $331.13 | Professional | None | $134.90 | $173.78 | $331.13 |
Well Sense Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
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 $40.74 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $40.74 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $29.51 | Professional | 53 · Discontinued | $16.60 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $97.72 Typical High $112.20 | Professional | 54 · Surgery only | $61.66 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $22.39 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $14.79 |
Where New Hampshire sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 13th of 51
$209
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.