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 $97.72 Median $104.71 Typical High $128.82 | Professional | None | $97.72 | $104.71 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $218.78 | Professional | None | $85.11 | $131.83 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $199.53 | Facility | None | $100.00 | $158.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $323.59 | Professional | None | $123.03 | $186.21 | $323.59 |
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 $100.00 Median $158.49 Typical High $316.23 | Professional | None | $100.00 | $158.49 | $316.23 |
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 $117.49 Median $158.49 Typical High $269.15 | Professional | None | $117.49 | $158.49 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
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 $48.98 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $19.50 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $79.43 Typical High $97.72 | Professional | 54 · Surgery only | $74.13 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $69.18 | $74.13 | $91.20 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 17th of 51
$155
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.