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 $107.15 Median $208.93 Typical High $323.59 | Professional | None | $107.15 | $208.93 | $323.59 |
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 $112.20 Median $223.87 Typical High $338.84 | Professional | None | $112.20 | $223.87 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $309.03 | Facility | None | $100.00 | $245.47 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $707.95 | Professional | None | $173.78 | $363.08 | $707.95 |
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 $323.59 Typical High $812.83 | Professional | None | $138.04 | $323.59 | $812.83 |
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 $154.88 Median $302.00 Typical High $660.69 | Professional | None | $154.88 | $302.00 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $53.70 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $53.70 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $21.38 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $81.28 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $16.22 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.72 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $75.86 | $131.83 | $147.91 |
Where New Hampshire sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$269
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.