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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $239.88 | Professional | None | $131.83 | $165.96 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $114.82 Median $208.93 Typical High $398.11 | Professional | None | $114.82 | $208.93 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $309.03 | Facility | None | $100.00 | $245.47 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $575.44 | Professional | None | $147.91 | $269.15 | $575.44 |
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 $173.78 Median $309.03 Typical High $645.65 | Professional | None | $173.78 | $309.03 | $645.65 |
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 $169.82 Median $281.84 Typical High $537.03 | Professional | None | $169.82 | $281.84 | $537.03 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
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 $66.07 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $151.36 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$240
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.