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 $208.93 Median $245.47 Typical High $316.23 | Professional | None | $208.93 | $245.47 | $316.23 |
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 $158.49 Median $281.84 Typical High $354.81 | Professional | None | $158.49 | $281.84 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $489.78 Typical High $691.83 | Professional | 50 · Both sides | $331.13 | $489.78 | $691.83 |
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 $234.42 Median $407.38 Typical High $741.31 | Professional | None | $234.42 | $407.38 | $741.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $691.83 | Professional | None | $186.21 | $338.84 | $691.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $660.69 | Professional | None | $218.78 | $363.08 | $660.69 |
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 $104.71 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $41.69 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $239.88 | Professional | 54 · Surgery only | $154.88 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $37.15 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $173.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $144.54 | $173.78 | $223.87 |
Where New Hampshire sits
The same service costs 4.1 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
$309
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.