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 $338.84 Median $398.11 Typical High $457.09 | Professional | None | $338.84 | $398.11 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $891.25 | Professional | None | $309.03 | $467.74 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $616.60 | Facility | None | $338.84 | $436.52 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $1,380.38 | Professional | None | $389.05 | $602.56 | $1,380.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $1,412.54 | Professional | None | $436.52 | $741.31 | $1,412.54 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,230.27 | Professional | None | $407.38 | $630.96 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
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 $169.82 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $323.59 |
Where New Hampshire sits
The same service costs 6.0 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
$550
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.