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 $158.49 Median $204.17 Typical High $9,772.37 | Facility | None | $158.49 | $204.17 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $457.09 | Professional | None | $158.49 | $204.17 | $457.09 |
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 $165.96 Median $251.19 Typical High $478.63 | Professional | None | $165.96 | $251.19 | $478.63 |
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 $199.53 Median $323.59 Typical High $724.44 | Professional | None | $199.53 | $323.59 | $724.44 |
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 $229.09 Median $398.11 Typical High $758.58 | Professional | None | $229.09 | $398.11 | $758.58 |
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 $218.78 Median $323.59 Typical High $602.56 | Professional | None | $218.78 | $323.59 | $602.56 |
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 $79.43 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $79.43 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $31.62 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.85 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $134.90 | $169.82 |
Where New Hampshire sits
The same service costs 4.7 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· 17th of 51
$309
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.