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 $194.98 Median $218.78 Typical High $302.00 | Professional | None | $194.98 | $218.78 | $302.00 |
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 $151.36 Median $269.15 Typical High $338.84 | Professional | None | $151.36 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $457.09 Typical High $660.69 | Professional | 50 · Both sides | $316.23 | $457.09 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $371.54 Typical High $575.44 | Facility | None | $281.84 | $371.54 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $691.83 | Professional | None | $223.87 | $380.19 | $691.83 |
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 $177.83 Median $316.23 Typical High $645.65 | Professional | None | $177.83 | $316.23 | $645.65 |
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 $204.17 Median $338.84 Typical High $616.60 | Professional | None | $204.17 | $338.84 | $616.60 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
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 $97.72 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $162.18 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $162.18 | $208.93 |
Where New Hampshire sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 20th of 51
$288
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.