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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,412.54 | Professional | None | $524.81 | $630.96 | $1,412.54 |
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 $512.86 Median $758.58 Typical High $1,445.44 | Professional | None | $512.86 | $758.58 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $2,691.53 | Facility | None | $660.69 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $2,137.96 | Professional | None | $616.60 | $954.99 | $2,137.96 |
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 $691.83 Median $1,174.90 Typical High $2,344.23 | Professional | None | $691.83 | $1,174.90 | $2,344.23 |
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 $660.69 Median $954.99 Typical High $1,819.70 | Professional | None | $660.69 | $954.99 | $1,819.70 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
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 $263.03 Median $302.00 Typical High $354.81 | Professional | 52 · Reduced service | $263.03 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $104.71 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $389.05 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $72.44 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $501.19 |
Where New Hampshire sits
The same service costs 4.3 times more in Alaska than in Texas. 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
$912
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.