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 $42.66 Median $44.67 Typical High $54.95 | Professional | None | $42.66 | $44.67 | $54.95 |
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 $42.66 Median $66.07 Typical High $117.49 | Professional | None | $42.66 | $66.07 | $117.49 |
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 $53.70 Median $75.86 Typical High $158.49 | Professional | None | $53.70 | $75.86 | $158.49 |
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 $52.48 Median $91.20 Typical High $169.82 | Professional | None | $52.48 | $91.20 | $169.82 |
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 $51.29 Median $77.62 Typical High $134.90 | Professional | None | $51.29 | $77.62 | $134.90 |
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 $20.89 Median $22.39 Typical High $26.92 | Professional | 52 · Reduced service | $20.89 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $10.72 | Professional | 53 · Discontinued | $8.32 | $8.91 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $39.81 | Professional | 54 · Surgery only | $31.62 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.76 Typical High $7.94 | Professional | 55 · Aftercare only | $6.31 | $6.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $30.90 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $29.51 | $30.90 | $37.15 |
Where New Hampshire sits
The same service costs 4.6 times more in Alaska than in New York. 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· 16th of 51
$70.79
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.