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 $52.48 Median $117.49 Typical High $218.78 | Professional | None | $52.48 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $218.78 | Professional | None | $47.86 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $173.78 Typical High $416.87 | Professional | 50 · Both sides | $117.49 | $173.78 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $316.23 | Professional | None | $64.57 | $151.36 | $316.23 |
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 $56.23 Median $147.91 Typical High $346.74 | Professional | None | $56.23 | $147.91 | $346.74 |
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 $69.18 Median $158.49 Typical High $323.59 | Professional | None | $69.18 | $158.49 | $323.59 |
4 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 $26.30 Median $57.54 Typical High $109.65 | Professional | 52 · Reduced service | $26.30 | $57.54 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $23.44 Typical High $43.65 | Professional | 53 · Discontinued | $10.47 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $17.38 Typical High $32.36 | Professional | 55 · Aftercare only | $7.94 | $17.38 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $5.25 | $11.75 | $21.88 |
Where New Hampshire sits
The same service costs 2.7 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· 21st of 51
$132
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.