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 $61.66 Median $141.25 Typical High $190.55 | Professional | None | $61.66 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $147.91 Typical High $263.03 | Professional | None | $51.29 | $147.91 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $173.78 Typical High $371.54 | Professional | None | $75.86 | $173.78 | $371.54 |
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 $66.07 Median $173.78 Typical High $407.38 | Professional | None | $66.07 | $173.78 | $407.38 |
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 $85.11 Median $186.21 Typical High $389.05 | Professional | None | $85.11 | $186.21 | $389.05 |
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 $30.90 Median $70.79 Typical High $95.50 | Professional | 52 · Reduced service | $30.90 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $28.18 Typical High $38.02 | Professional | 53 · Discontinued | $12.59 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $104.71 Typical High $141.25 | Professional | 54 · Surgery only | $46.77 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $9.33 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $14.13 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.17 | $14.13 | $19.05 |
Where New Hampshire sits
The same service costs 3.7 times more in Wisconsin 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· 27th of 51
$151
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.