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 $177.83 Median $363.08 Typical High $489.78 | Professional | None | $177.83 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $478.63 | Professional | None | $144.54 | $295.12 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $416.87 Typical High $831.76 | Professional | None | $204.17 | $416.87 | $831.76 |
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 $173.78 Median $436.52 Typical High $1,023.29 | Professional | None | $173.78 | $436.52 | $1,023.29 |
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 $229.09 Median $467.74 Typical High $912.01 | Professional | None | $229.09 | $467.74 | $912.01 |
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 $89.13 Median $181.97 Typical High $245.47 | Professional | 52 · Reduced service | $89.13 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $72.44 Typical High $100.00 | Professional | 53 · Discontinued | $36.31 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $275.42 Typical High $371.54 | Professional | 54 · Surgery only | $134.90 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $54.95 Typical High $74.13 | Professional | 55 · Aftercare only | $26.92 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $17.78 | $36.31 | $48.98 |
Where New Hampshire sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 20th of 51
$363
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.