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 $104.71 Median $416.87 Typical High $8,912.51 | Facility | None | $104.71 | $416.87 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $389.05 Typical High $501.19 | Professional | None | $95.50 | $389.05 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $186.21 Typical High $676.08 | Professional | None | $61.66 | $186.21 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $288.40 Typical High $1,023.29 | Professional | None | $91.20 | $288.40 | $1,023.29 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $416.87 Typical High $1,122.02 | Professional | None | $75.86 | $416.87 | $1,122.02 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
United Setting Professional Modifier None Typical Low $97.72 Median $398.11 Typical High $891.25 | Professional | None | $97.72 | $398.11 | $891.25 |
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 $47.86 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $47.86 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $19.05 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $70.79 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $14.13 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $9.55 | $38.90 | $41.69 |
Where New Hampshire sits
The same service costs 5.6 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· 45th of 51
$269
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.