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 $125.89 Median $229.09 Typical High $371.54 | Professional | None | $125.89 | $229.09 | $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 $100.00 Median $208.93 Typical High $309.03 | Professional | None | $100.00 | $208.93 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $616.60 | Professional | None | $147.91 | $302.00 | $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 $295.12 Typical High $741.31 | Professional | None | $125.89 | $295.12 | $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 $162.18 Median $331.13 Typical High $660.69 | Professional | None | $162.18 | $331.13 | $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 $63.10 Median $120.23 Typical High $186.21 | Professional | 52 · Reduced service | $63.10 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $47.86 Typical High $74.13 | Professional | 53 · Discontinued | $25.12 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $181.97 Typical High $275.42 | Professional | 54 · Surgery only | $95.50 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $36.31 Typical High $54.95 | Professional | 55 · Aftercare only | $19.05 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $23.99 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.59 | $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· 26th 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.