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 Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,778.28 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,778.28 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,380.38 Typical High $1,819.70 | Facility | None | $630.96 | $1,380.38 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,344.23 | $4,786.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,348.96 | $2,290.87 | $4,265.80 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,344.23 | $4,073.80 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
5 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 $812.83 Median $891.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $812.83 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $331.13 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,445.44 |
Where New Hampshire sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 21st of 51
$2,042
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.