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 $776.25 Median $933.25 Typical High $11,481.54 | Facility | None | $776.25 | $933.25 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $2,238.72 | Professional | None | $776.25 | $933.25 | $2,238.72 |
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 $707.95 Median $1,096.48 Typical High $2,041.74 | Professional | None | $707.95 | $1,096.48 | $2,041.74 |
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 $891.25 Median $1,348.96 Typical High $3,019.95 | Professional | None | $891.25 | $1,348.96 | $3,019.95 |
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 $1,000.00 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,659.59 | $3,311.31 |
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 $977.24 Median $1,380.38 Typical High $2,630.27 | Professional | None | $977.24 | $1,380.38 | $2,630.27 |
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 $389.05 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $616.60 | $707.95 |
Where New Hampshire sits
The same service costs 4.5 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· 15th of 51
$1,259
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.