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 $630.96 Median $724.44 Typical High $891.25 | Professional | None | $630.96 | $724.44 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS 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 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $3,019.95 | Facility | None | $630.96 | $2,398.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,630.27 | Professional | None | $776.25 | $1,230.27 | $2,630.27 |
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 $851.14 Median $1,548.82 Typical High $3,019.95 | Professional | None | $851.14 | $1,548.82 | $3,019.95 |
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 $758.58 Median $1,202.26 Typical High $2,238.72 | Professional | None | $758.58 | $1,202.26 | $2,238.72 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
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 $309.03 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $125.89 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $467.74 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $616.60 |
Where New Hampshire sits
The same service costs 4.9 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· 13th of 51
$1,202
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.