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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $549.54 | Professional | None | $354.81 | $457.09 | $549.54 |
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 $295.12 Median $467.74 Typical High $630.96 | Professional | None | $295.12 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $891.25 Typical High $1,230.27 | Professional | 50 · Both sides | $588.84 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,862.09 | Facility | None | $575.44 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,318.26 | Professional | None | $426.58 | $676.08 | $1,318.26 |
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 $346.74 Median $602.56 Typical High $1,148.15 | Professional | None | $346.74 | $602.56 | $1,148.15 |
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 $407.38 Median $630.96 Typical High $1,122.02 | Professional | None | $407.38 | $630.96 | $1,122.02 |
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 $186.21 Median $204.17 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $380.19 |
Where New Hampshire sits
The same service costs 4.9 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· 19th of 51
$550
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.