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 $371.54 Median $389.05 Typical High $389.05 | Professional | None | $371.54 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,202.26 | Professional | None | $398.11 | $588.84 | $1,202.26 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,047.13 | Professional | None | $389.05 | $537.03 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $181.97 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $38.90 |
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· 17th of 51
$513
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.