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 $389.05 Median $524.81 Typical High $741.31 | Professional | None | $389.05 | $524.81 | $741.31 |
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 $338.84 Median $630.96 Typical High $1,174.90 | Professional | None | $338.84 | $630.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,570.40 Typical High $3,548.13 | Facility | None | $575.44 | $2,570.40 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $1,584.89 | Professional | None | $478.63 | $758.58 | $1,584.89 |
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 $478.63 Median $831.76 Typical High $1,862.09 | Professional | None | $478.63 | $831.76 | $1,862.09 |
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 $467.74 Median $707.95 Typical High $1,479.11 | Professional | None | $467.74 | $707.95 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $194.98 Median $263.03 Typical High $371.54 | Professional | 52 · Reduced service | $194.98 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $104.71 Typical High $147.91 | Professional | 53 · Discontinued | $77.62 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $288.40 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $52.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $38.90 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $363.08 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $269.15 | $363.08 | $524.81 |
Where New Hampshire sits
The same service costs 4.4 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· 16th of 51
$708
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.