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 $213.80 Median $269.15 Typical High $6,025.60 | Facility | None | $213.80 | $269.15 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $676.08 | Professional | None | $213.80 | $269.15 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $645.65 | Professional | None | $229.09 | $338.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,862.09 | Facility | None | $575.44 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $977.24 | Professional | None | $269.15 | $436.52 | $977.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,047.13 | Professional | None | $295.12 | $549.54 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $812.83 | Professional | None | $263.03 | $436.52 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
6 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 $107.15 Median $128.82 Typical High $162.18 | Professional | 52 · Reduced service | $107.15 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $42.66 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $158.49 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $48.98 | Professional | 55 · Aftercare only | $31.62 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.70 Typical High $32.36 | Professional | 56 · Pre-op care only | $21.38 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $181.97 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $147.91 | $181.97 | $229.09 |
Where New Hampshire sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
$427
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.