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 $74.13 Median $104.71 Typical High $190.55 | Professional | None | $74.13 | $104.71 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $234.42 | Professional | None | $63.10 | $128.82 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $295.12 | Professional | None | $89.13 | $151.36 | $295.12 |
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 $75.86 Median $151.36 Typical High $331.13 | Professional | None | $75.86 | $151.36 | $331.13 |
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 $95.50 Median $151.36 Typical High $316.23 | Professional | None | $95.50 | $151.36 | $316.23 |
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 $37.15 Median $52.48 Typical High $70.79 | Professional | 52 · Reduced service | $37.15 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $28.84 | Professional | 53 · Discontinued | $14.79 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $79.43 Typical High $107.15 | Professional | 54 · Surgery only | $56.23 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $21.38 | Professional | 55 · Aftercare only | $11.22 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $14.45 |
Where New Hampshire sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 14th of 51
$138
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.