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 $114.82 Median $162.18 Typical High $295.12 | Professional | None | $114.82 | $162.18 | $295.12 |
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 $100.00 Median $181.97 Typical High $338.84 | Professional | None | $100.00 | $181.97 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $263.03 | Facility | None | $100.00 | $208.93 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $501.19 | Professional | None | $128.82 | $239.88 | $501.19 |
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 $151.36 Median $263.03 Typical High $549.54 | Professional | None | $151.36 | $263.03 | $549.54 |
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 $147.91 Median $245.47 Typical High $457.09 | Professional | None | $147.91 | $245.47 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $57.54 Median $69.18 Typical High $93.33 | Professional | 52 · Reduced service | $57.54 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.18 Typical High $37.15 | Professional | 53 · Discontinued | $22.91 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $104.71 Typical High $138.04 | Professional | 54 · Surgery only | $85.11 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $97.72 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $79.43 | $97.72 | $128.82 |
Where New Hampshire sits
The same service costs 3.5 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· 13th of 51
$209
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.