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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | None | $162.18 | $275.42 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $489.78 | Professional | None | $204.17 | $316.23 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $2,691.53 | Facility | None | $489.78 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $537.03 | Professional | None | $218.78 | $281.84 | $537.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $436.52 | Professional | None | $169.82 | $257.04 | $436.52 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $436.52 | Professional | None | $194.98 | $269.15 | $436.52 |
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 $81.28 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $27.54 | $27.54 |
Where New Hampshire sits
The same service costs 4.5 times more in Alaska than in New York. 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
$282
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.