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 $134.90 Median $186.21 Typical High $8,912.51 | Facility | None | $134.90 | $186.21 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $158.49 | Professional | None | $120.23 | $134.90 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $218.78 | Professional | None | $125.89 | $165.96 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $213.80 | Facility | None | $100.00 | $169.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $389.05 | Professional | None | $162.18 | $190.55 | $389.05 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $371.54 | Professional | None | $138.04 | $199.53 | $371.54 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $316.23 | Professional | None | $141.25 | $177.83 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
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 $61.66 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $61.66 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $27.54 | Professional | 53 · Discontinued | $24.55 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $102.33 Typical High $104.71 | Professional | 54 · Surgery only | $91.20 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $95.50 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $85.11 | $95.50 | $97.72 |
Where New Hampshire sits
The same service costs 5.1 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· 17th of 51
$174
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.