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 $77.62 Median $154.88 Typical High $251.19 | Professional | None | $77.62 | $154.88 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $309.03 | Professional | None | $61.66 | $162.18 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $467.74 | Professional | None | $87.10 | $204.17 | $467.74 |
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 $79.43 Median $194.98 Typical High $426.58 | Professional | None | $79.43 | $194.98 | $426.58 |
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 $93.33 Median $218.78 Typical High $467.74 | Professional | None | $93.33 | $218.78 | $467.74 |
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 $41.69 Median $77.62 Typical High $125.89 | Professional | 52 · Reduced service | $41.69 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $30.90 Typical High $50.12 | Professional | 53 · Discontinued | $16.60 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $114.82 Typical High $186.21 | Professional | 54 · Surgery only | $63.10 | $114.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.91 Typical High $37.15 | Professional | 55 · Aftercare only | $12.59 | $22.91 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.49 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.32 | $15.49 | $25.12 |
Where New Hampshire sits
The same service costs 2.7 times more in Wisconsin 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· 30th of 51
$174
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.