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 $173.78 Median $457.09 Typical High $9,772.37 | Facility | None | $173.78 | $457.09 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $512.86 | Professional | None | $173.78 | $363.08 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $141.25 Median $288.40 Typical High $478.63 | Professional | None | $141.25 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $1,778.28 | Facility | None | $537.03 | $1,412.54 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $891.25 | Professional | None | $204.17 | $457.09 | $891.25 |
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 $165.96 Median $407.38 Typical High $933.25 | Professional | None | $165.96 | $407.38 | $933.25 |
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 $199.53 Median $398.11 Typical High $870.96 | Professional | None | $199.53 | $398.11 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
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 $87.10 Median $158.49 Typical High $229.09 | Professional | 52 · Reduced service | $87.10 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $63.10 Typical High $93.33 | Professional | 53 · Discontinued | $34.67 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $128.82 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $25.70 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $17.38 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $218.78 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $120.23 | $218.78 | $323.59 |
Where New Hampshire sits
The same service costs 4.0 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· 30th of 51
$331
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.