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 $47.86 Median $91.20 Typical High $8,912.51 | Facility | None | $47.86 | $91.20 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $194.98 | Professional | None | $63.10 | $102.33 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $229.09 | Professional | None | $104.71 | $131.83 | $229.09 |
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 $63.10 Median $100.00 Typical High $162.18 | Professional | None | $63.10 | $100.00 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $295.12 | Professional | None | $77.62 | $144.54 | $295.12 |
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 $89.13 Median $165.96 Typical High $346.74 | Professional | None | $89.13 | $165.96 | $346.74 |
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 $81.28 Median $144.54 Typical High $275.42 | Professional | None | $81.28 | $144.54 | $275.42 |
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 $31.62 Median $43.65 Typical High $57.54 | Professional | 52 · Reduced service | $31.62 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $17.38 Typical High $23.44 | Professional | 53 · Discontinued | $12.59 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $66.07 Typical High $87.10 | Professional | 54 · Surgery only | $46.77 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.18 Typical High $17.38 | Professional | 55 · Aftercare only | $9.55 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.71 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.31 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $61.66 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $43.65 | $61.66 | $81.28 |
Where New Hampshire sits
The same service costs 3.9 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· 22nd of 51
$117
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.