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 $131.83 Median $275.42 Typical High $389.05 | Professional | None | $131.83 | $275.42 | $389.05 |
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 $100.00 Median $208.93 Typical High $316.23 | Professional | None | $100.00 | $208.93 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $630.96 | Professional | None | $154.88 | $309.03 | $630.96 |
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 $758.58 | Professional | None | $125.89 | $302.00 | $758.58 |
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 $346.74 Typical High $691.83 | Professional | None | $165.96 | $346.74 | $691.83 |
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 $66.07 Median $123.03 Typical High $194.98 | Professional | 52 · Reduced service | $66.07 | $123.03 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $48.98 Typical High $77.62 | Professional | 53 · Discontinued | $26.30 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $186.21 Typical High $295.12 | Professional | 54 · Surgery only | $97.72 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $37.15 Typical High $58.88 | Professional | 55 · Aftercare only | $19.50 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $24.55 Typical High $38.90 | Professional | 56 · Pre-op care only | $13.18 | $24.55 | $38.90 |
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· 28th of 51
$257
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.