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 $190.55 Median $616.60 Typical High $9,772.37 | Facility | None | $190.55 | $616.60 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $371.54 | Professional | None | $128.82 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $316.23 | Professional | None | $102.33 | $208.93 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $616.60 | Professional | None | $151.36 | $309.03 | $616.60 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $741.31 | Professional | None | $125.89 | $302.00 | $741.31 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
United Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $660.69 | Professional | None | $165.96 | $338.84 | $660.69 |
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 $64.57 Median $120.23 Typical High $186.21 | Professional | 52 · Reduced service | $64.57 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $48.98 Typical High $74.13 | Professional | 53 · Discontinued | $25.70 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $181.97 Typical High $281.84 | Professional | 54 · Surgery only | $97.72 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $36.31 Typical High $56.23 | Professional | 55 · Aftercare only | $19.50 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $23.99 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.88 | $23.99 | $37.15 |
Where New Hampshire sits
The same service costs 3.4 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· 27th of 51
$251
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.